NPIMap

Individual provider Active NPI

Cody Andersen, D.O.

  • Emergency Medicine Physician
  • Johnstown, PA
National Provider Identifier
1326478074
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OT015619 Issued in PA
Practice address
1086 Franklin St
Johnstown, PA 15905-4305
Phone
(510) 402-8559
NPI assigned
Nov 16, 2013
Last updated
Apr 30, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT015619 PA Primary

Addresses

Primary practice location

1086 Franklin St
Johnstown, PA 15905-4305

Mailing address

1086 Franklin St
Johnstown, PA 15905-4305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180221001434 CA Practitioner - Emergency Medicine 4981822277 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Western University of Health Sciences College of Dental Med, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Emergency Medical Group IncGroup PAC ID 2860542479, 24 clinicians

Practice addresses (Care Compare)

1000 Greenley Rd
Sonora, CA 95370-5200
Phone (209) 536-5000

14540 Mono Way
Sonora, CA 95370-8858
Phone (209) 536-6680

23 N Main St
Suite 101
Angels Camp, CA 95222-8001
Phone (209) 736-9130

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as group
Quality
90.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT015619PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 1, 2023 Accepting new patients
Adventist Health Physicians Network CurrentSince Dec 1, 2023 Accepting new patients
Community Medical Team Acute Care Corporation Emergency Medicine CurrentSince Apr 1, 2024 Accepting new patients
Sonora Community Hospital CurrentSince Mar 21, 2018 Accepting new patients
Sonora Community Hospital CurrentSince Mar 21, 2018 Accepting new patients
Sonora Community Hospital Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Adventist Health California Medical Group, Inc. Past Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients
Sierra Rural Physicians, Inc. Emergency Medicine Past Accepting new patients

Locations

23 N Main St
Angels Camp, CA 95222
Phone (209) 736-9130

23 N Main St
Ste 101
Angels Camp, CA 95222

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

1000 Greenley Rd
Sonora, CA 95370
Phone (209) 263-0803

14540 State Highway 108
Sonora, CA 95370
Phone (209) 532-3167

1801 E March Ln
Ste C300
Stockton, CA 95210
Phone (209) 464-6422

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1384560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1326478074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "510-402-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-16",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT015619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.