Individual provider Active NPI

David R Anderson, MD

  • Diagnostic Ultrasound Physician
  • Lansing, MI
National Provider Identifier
1366491664
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
4301076201 Issued in MI
Practice address
3520 Forest Rd FL 3
Lansing, MI 48910-3720
Phone
(517) 975-6425
Fax
(517) 975-6430
NPI assigned
May 6, 2006
Last updated
Jun 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 4301076201 MI Primary

Addresses

Primary practice location

3520 Forest Rd FL 3
Lansing, MI 48910-3720

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 975-6425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20040428000450 MI Practitioner - Diagnostic Radiology 1153318563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical School at San Antonio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

3520 Forest Rd
FL 3
Lansing, MI 48910-3720
Phone (517) 975-6425

4660 S Hagadorn Rd
Suite 500
East Lansing, MI 48823-6804
Phone (517) 884-4554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076201MIMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. Diagnostic Ultrasound CurrentSince May 1, 2025 Accepting new patients
Breast Center of Lansing PLLC PastSince Apr 1, 2004 Accepting new patients
Ingham Radiology Associates, PC Past Accepting new patients
Advanced Radiology Services PC Past Accepting new patients

Locations

4660 S Hagadorn Rd
Ste 600
East Lansing, MI 48823
Phone (517) 267-2460

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

Interoperability endpoints

  • Direct secure messaging: david.anderson.1@25394.direct.athenahealth.com

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 1

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1366491664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-975-6425",
            "fax_number": "517-975-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 FOREST RD FL 3",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103720",
            "telephone_number": "517-975-6425",
            "fax_number": "517-975-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MI",
            "license": "4301076201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.