Active NPI
Eric Jon Anderson, M.D.
- Pediatric Hematology & Oncology Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- A91428
- Practice address
- 3010 Childrens Way
2-West
San Diego, CA 92123-4223 - Phone
- (858) 966-5811
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A91428 | CA | |
| Pediatric Hematology & Oncology Physician | 2080P0207X | A91428 | CA | Primary |
Addresses
Primary practice location
3010 Childrens Way
2-West
San Diego, CA 92123-4223
Mailing address
3860 Calle Fortunada
Suite 210
San Diego, CA 92123-4800
Phone (858) 309-6303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A914280 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- Education
- University of Minnesota Medical School, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3010 Childrens Way
San Diego, CA 92123-4223
Phone (858) 576-1700
3020 Children'S Way
San Diego, CA 92123-4223
Phone (858) 576-1700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A91428 | CA | MD | Pediatric Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rady Children'S Hospital San Diego | Current | Accepting new patients | |
| Rady Children'S Hospital San Diego | Pediatrics | Current | Accepting new patients |
| Children'S Specialists of San Diego, Inc. (CSSD) | Pediatrics | Past | Accepting new patients |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Locations
25170 Hancock Ave
Murrieta, CA 92562
Phone (858) 757-3277
3010 Childrens Way
Fl 2
San Diego, CA 92123
Phone (858) 966-5811
3020 Childrens Way
#5003
San Diego, CA 92123
Phone (858) 309-6300
3010 Childrens Way
#2
San Diego, CA 92123
Phone (858) 966-5811
3020 Childrens Way
San Diego, CA 92123
Phone (858) 966-5841
Interoperability endpoints
- eanderson8774@radychildrens.direct-ci.com
Organizations & group practices 4
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.
-
- Pediatrics Physician
- San Diego, CA
- NPI 1669617197
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
- Pediatrics Physician
- San Diego, CA
- NPI 1801959127
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314662400000",
"number": "1346312964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3860 CALLE FORTUNADA",
"address_2": "SUITE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234800",
"telephone_number": "858-309-6303",
"fax_number": "858-309-6301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 CHILDRENS WAY",
"address_2": "2-WEST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-966-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ERIC",
"middle_name": "JON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2011-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A91428",
"primary": false
},
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "CA",
"license": "A91428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A914280",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.