Individual provider Active NPI

Kristen Marie Anderson, M.D., PH.D.

  • Gynecologic Oncology Physician
  • Moreno Valley, CA
National Provider Identifier
1447575568
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
A129812 Issued in CA
Practice address
26520 Cactus Ave Ste B2020
Moreno Valley, CA 92555-3927
Phone
(951) 486-4000
NPI assigned
Mar 31, 2010
Last updated
Feb 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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 A129812 CA Primary

Addresses

Primary practice location

26520 Cactus Ave Ste B2020
Moreno Valley, CA 92555-3927

Mailing address

26520 Cactus Ave Ste B2020
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150227001920 CA Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 9739405275 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Tufts University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

2195 Club Ctr Dr
San Bernardino, CA 92408-4162
Phone (909) 835-1750

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

26600 Cactus Ave
Moreno Valley, CA 92555-3901

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

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, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
129812CAMDClinical Social Worker
A129812CAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside CurrentSince Aug 1, 2020 Accepting new patients
Regents of the University of California Obstetrics & Gynecology CurrentSince Dec 10, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Regents of the University of California CurrentSince Dec 10, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 14, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince May 14, 2017 Accepting new patients
County of Riverside CurrentSince Aug 1, 2020 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

26520 Cactus Ave
Ste B2020
Moreno Valley, CA 92555
Phone (951) 486-6400

26600 Cactus Ave
Ste 300
Moreno Valley, CA 92555
Phone (800) 720-9553

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

2195 Club Center Dr
Ste A
Sn Bernrdno, CA 92408
Phone (909) 835-1750

Interoperability endpoints

  • Direct secure messaging: kanderson101107@direct.llu.edu

Organizations & group practices 10

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": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1447575568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE STE B2020",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE STE B2020",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "A129812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.