Jeremy Anderson, D.O.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

DO2732 Issued in NV

Practice address

1707 W Charleston Blvd Ste 160
Las Vegas, NV 89102-2354

Phone

(702) 671-5150

Fax

(702) 384-6493

NPI assigned

Jun 11, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

General Surgery

Education

Arizona College of Osteopathic Medicine Mid Western University, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Thunderbird Medical Center Hospital, Glendale, AZ, CCN 030089
• Banner del E. Webb Medical Center Hospital, Sun City West, AZ, CCN 030093
• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115
• Banner Boswell Medical Center Hospital, Sun City, AZ, CCN 030061

Merit-based Incentive Payment System (MIPS)

Final score

84.12 of 100Reported as group

Quality

76.35

Promoting interoperability

99

Improvement activities

40

Cost

71.55

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1821368218
  Medicare reassignment Care Compare group NPD
• Banner - University Physician Specialists LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1437529245
  Medicare reassignment NPD
• Banner - University Physician Specialists LLC

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1164255865
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1316228802
  NPD
• Banner Physician Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Page, AZ
  • NPI 1366799355
  NPD
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  NPD (past)

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

• Banner Boswell Medical Center

  • General Acute Care Hospital
  • Sun City, AZ
  • NPI 1952560914
  Care Compare affiliation
• Banner del E Webb Medical Center

  • General Acute Care Hospital
  • Sun City West, AZ
  • NPI 1588823553
  Care Compare affiliation
• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation
• Banner Thunderbird Medical Center

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1154355188
  Care Compare affiliation

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1457732760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-780-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 160",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022354",
            "telephone_number": "702-671-5150",
            "fax_number": "702-384-6493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr Ste 162",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841500",
            "country_code": "US",
            "telephone_number": "856-566-6708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "DO2732",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "NV",
            "license": "DO2732",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NV",
            "license": "DO2732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmine Anderson
• Jean Anderson
• Jeff Anderson
• Jennifer Anderson
• Jeremy Anderson, DPM
• Jeri Anderson
• Jessica N Anderson
• Jill Dutson Anderson, PA-C
• John Samuel Anderson, MD
• Jordan Anderson

• Surgical Critical Care Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Surgical Critical Care Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.

Verify at the official NPI Registry.