Individual provider Active NPI

Jeffrey Walter Anderson, D.O.

  • Spinal Cord Injury Medicine Physician
  • Salisbury, MD
National Provider Identifier
1255334454
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Spinal Cord Injury Medicine PhysicianTaxonomy code 2081P0004X
License
H45955 Issued in MD
Practice address
100 E Carroll St
#400
Salisbury, MD 21801-5422
Phone
(410) 543-7530
NPI assigned
May 23, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X H45955 MD
Spinal Cord Injury Medicine Physician 2081P0004X H45955 MD Primary

Addresses

Primary practice location

100 E Carroll St
#400
Salisbury, MD 21801-5422

Mailing address

614 Eastern Shore Dr Ste C
Salisbury, MD 21804-5940
Phone (443) 260-2660

Other identifiers 1

IdentifierTypeStateIssuer
125511800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20101018000999 MD Practitioner - Physical Medicine and Rehabilitation 0143413534 Reassigns benefits to 1 organization
I20221125000150 DE Practitioner - Physical Medicine and Rehabilitation 0143413534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pam Physician EnterpriseGroup PAC ID 1254628589, 34 clinicians

Practice addresses (Care Compare)

22303 Dupont Blvd
Georgetown, DE 19947-2153
Phone (717) 731-9660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ability Rehab Associates Physical Medicine & Rehabilitation CurrentSince Jun 1, 1994 Accepting new patients
Pam Physician Enterprise Physical Medicine & Rehabilitation CurrentSince Dec 1, 2022 Accepting new patients
Damd, Inc Past Accepting new patients
Camille Y Khawand PA Past Accepting new patients
Erica Harrington LCSW-C PastSince Sep 12, 2021 Accepting new patients

Locations

1240 McKee Rd
Dover, DE 19904
Phone (302) 672-5800

640 S State St
Dover, DE 19901
Phone (302) 744-4700

22303 DuPont Blvd
Georgetown, DE 19947
Phone (301) 664-2882

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

100 E Carroll St
#400
Salisbury, MD 21801
Phone (410) 219-5530

220 Tilghman Rd
Salisbury, MD 21804
Phone (410) 219-5530

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1255334454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 EASTERN SHORE DR STE C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045940",
            "telephone_number": "443-260-2660",
            "fax_number": "443-260-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "address_2": "#400",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-543-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEFFREY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "H45955",
            "primary": false
        },
        {
            "code": "2081P0004X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
            "state": "MD",
            "license": "H45955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125511800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.