Individual provider Active NPI

Patrick St. George Anderson, MD

  • Gynecologic Oncology Physician
  • South Orange, NJ
National Provider Identifier
1376548925
Registry record updated May 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
25MA07363800 Issued in NJ
Practice address
120 Irvington Ave
South Orange, NJ 07079-1904
Phone
(973) 762-7270
Fax
(973) 762-1980
NPI assigned
Jun 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 25MA07363800 NJ Primary

Addresses

Primary practice location

120 Irvington Ave
South Orange, NJ 07079-1904

Mailing address

120 Irvington Ave
South Orange, NJ 07079-1904
Phone (973) 762-7270

Other identifiers 2

IdentifierTypeStateIssuer
25MA07363800OtherNJMEDICAL LICENSES NUMBER
9003703MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20041210000278 NJ Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 3375457989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 467-9282

Hospital & facility affiliations

  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Oct 28, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Bronxcare Health System Gynecologic Oncology Past Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients

Locations

50 Union Ave
Fl 2
Irvington, NJ 07111
Phone (862) 339-0005

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

201 Lyons Ave
Ste L4
Newark, NJ 07112
Phone (973) 926-7205

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

120 Irvington Ave
South Orange, NJ 07079
Phone (973) 275-0025

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: panderson230091@epicdirect.rwjbh.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1119139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305590400000",
    "number": "1376548925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 IRVINGTON AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791904",
            "telephone_number": "973-762-7270",
            "fax_number": "973-762-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 IRVINGTON AVE",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791904",
            "telephone_number": "973-762-7270",
            "fax_number": "973-762-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PATRICK",
        "middle_name": "ST. GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-19",
        "last_updated": "2011-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NJ",
            "license": "25MA07363800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSES NUMBER",
            "identifier": "25MA07363800",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

Verify at the official NPI Registry.