NPIMap

Individual provider Active NPI

Ruric (Andy) Clesby Anderson, MD

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1205995255
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-093107 Issued in IL
Practice address
1020 N 12TH St
Internal Medicine Clinic Aurora Health Care
Milwaukee, WI 53233-1308
Phone
(414) 219-7887
Fax
(414) 219-7044
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-093107 IL Primary

Addresses

Primary practice location

1020 N 12TH St
Internal Medicine Clinic Aurora Health Care
Milwaukee, WI 53233-1308

Mailing address

1020 N 12TH St Ste 5120
Aurora Health Care
Milwaukee, WI 53233-1308
Phone (414) 219-7887

Other identifiers 2

IdentifierTypeStateIssuer
P00337332OtherILRAILROAD MEDICARE
036093106MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-093107ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nbimc Department of Cardio-Thoracic PastSince Jan 1, 2022 Accepting new patients
Robert Wood Johnson Medical Associates at Hamilton PA PastSince Jan 1, 2021 Accepting new patients
Nbimc Department of Non-Invasive PastSince Jan 1, 2022 Accepting new patients
New Jersey Rehabilitation PastSince Jul 1, 2025 Accepting new patients
New Jersey Spine Center, LLC PastSince Jun 7, 2024 Accepting new patients
Toms River West Ambulatory Surgery Center, LLC PastSince Jan 1, 2025 Accepting new patients
WRB Healthcare LLC PastSince Aug 1, 2025 Accepting new patients
Nbimc Department of Radiology PastSince Jan 1, 2015 Accepting new patients
MMC Provider Services Internal Medicine PastSince Jan 1, 2022 Accepting new patients
Aurora Medical Group, Inc. PastSince Jun 1, 2015 Accepting new patients
Ophthalmology NJ LLC PastSince Jan 1, 2024 Accepting new patients
CCG Medical Group LLC PastSince Jan 1, 2023 Accepting new patients
Arthritis and Allergy Associates LLC PastSince Dec 1, 2025 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty PastSince Jan 1, 2022 Accepting new patients
Rwjbh Observation Associates LLC Internal Medicine PastSince Nov 30, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: randerson16670@epicdirect.rwjbh.org

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327449600000",
    "number": "1205995255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST STE 5120",
            "address_2": "AURORA HEALTH CARE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-219-7887",
            "fax_number": "414-219-7044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N 12TH ST",
            "address_2": "INTERNAL MEDICINE CLINIC AURORA HEALTH CARE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331308",
            "telephone_number": "414-219-7887",
            "fax_number": "414-219-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RURIC (ANDY)",
        "middle_name": "CLESBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-093107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00337332",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093106",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.