Individual provider Active NPI

Alex Anderson, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Lake Charles, LA
National Provider Identifier
1295155778
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
208128 Issued in LA
Practice address
1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone
(337) 721-7236
Fax
(337) 721-7237
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Hospital & facility affiliations 10

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

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopaedics and Spine LLC 32 clinicians

Practice addresses (Care Compare)

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236

Hospital & facility affiliations

  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060
  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
  • Christus Ochsner Lake Area Hospital Hospital, Lake Charles, LA, CCN 190201
  • Christus St Patrick Hospital Inpatient rehabilitation facility, Lake Charles, LA, CCN 19T027

Merit-based Incentive Payment System (MIPS)

Final score
77.95 of 100Reported as individual
Quality
47.57
Promoting interoperability
97
Improvement activities
40
Cost
81.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue93
Removal of skin lesions15

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20180718001114 LA Practitioner - Family PracticePractitioner - Sports Medicine 6305062431 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208128LAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopaedics and Spine LLC Sports Medicine CurrentSince Mar 2, 2020 Accepting new patients
Center for Orthopaedics and Spine LLC Sports Medicine CurrentSince Mar 2, 2020 Accepting new patients
Imperial Health LLP Past Accepting new patients

Locations

1355 Sam Houston Jones Pkwy
Ste 340
Lake Charles, LA 70611
Phone (337) 721-7236

1747 Imperial Blvd
Ste B
Lake Charles, LA 70605
Phone (337) 312-8284

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236

Interoperability endpoints

  • Direct secure messaging: aanderson@direct.centerforortho.com
  • Direct secure messaging: aanderson5311879@direct.casso.us.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 208128 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

1747 Imperial Blvd
Lake Charles, LA 70605-5362

Mailing address

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236

Other practice location 1

1525 Oak Park Blvd.
Lake Charles, LA 70601
Phone (337) 494-6767

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2019.

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1295155778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Oak Park Blvd.",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "70601",
            "country_code": "US",
            "telephone_number": "337-494-6767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ALEX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "LA",
            "license": "208128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.