Mark Ian Anderson, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD60194935 Issued in WA

Practice address

450 S Kitsap Blvd Ste 210
Port Orchard, WA 98366-3738

Phone

(360) 895-8950

Fax

(360) 895-8980

NPI assigned

Feb 9, 2006

Last updated

Nov 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

West Virginia University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: manderson60579@fhsce.catholichealth.net

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

• Multicare Health System

  dba Multicare Neurological Surgery

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  dba MultiCare Deaconess Retail Pharmacy

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  dba MultiCare Immediate Clinic

  • Family Medicine Physician
  • Tacoma, WA
  • NPI 1750833844
  NPD
• Multicare Health System

  dba Auburn MultiCare Clinic

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195
  NPD (past)
• Multicare Health System

  dba Trauma Trust

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1114972791
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  dba Tacoma General Allenmore

  • General Acute Care Hospital
  • Tacoma, WA
  • NPI 1366556227
  Care Compare affiliation
• Multicare Health System

  dba MultiCare Good Samaritan Hospital

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1215900303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 210",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-895-8950",
            "fax_number": "360-895-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD STE 210",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663738",
            "telephone_number": "360-895-8950",
            "fax_number": "360-895-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARK",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60194935",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IN",
            "license": "01053155A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2011203",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "manderson60579@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "450 S Kitsap Blvd Ste 210",
            "city": "Port Orchard",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983663738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alliance Support Solutions
• American Pika Healthcare LLC
• Tareylon Symone Ancrum
• Cassandra Andersen, L.M.P.
• Jade Lee Anderson
• Andrew J. Tellington DMD, P.C. (West Sound Oral Surgery)
• Cynthia Alina Anno, LMT
• Tamara Ann Anthony-Ryder, MFT
• Joaquin Antoine
• Donna Marie Arcuri, P.T.A.

• Urology Physician in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Urology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.