NPIMap

Organization Active NPI

John P Anderson MD Russell M Perry MD and Mark a Sharzer MD a Med CRP

  • Radiology Clinic/Center
  • Anaheim, CA
National Provider Identifier
1467567511
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
JOHN P ANDERSON MD RUSSELL M PERRY MD AND MARK A SHARZER MD A MED CRP
Practice address
3033 West Orange Ave.
Anaheim, CA 92804
Phone
(714) 229-4060
NPI assigned
Aug 20, 2006
Last updated
Jun 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Authorized official

Name
Dr. Mark A Sharzer, M.D.
Title
Authorized Official
Phone
(714) 229-4060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X CA Primary

Addresses

Primary practice location

3033 West Orange Ave.
Anaheim, CA 92804

Mailing address

PO Box 646
Stanton, CA 90680-0646
Phone (562) 809-3513

Other identifiers 1

IdentifierTypeStateIssuer
GR0066250MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051117000698 CA Part B Supplier - Clinic/Group Practice 5496774580 Receives reassigned benefits from 17 practitioners
Practice locations: Anaheim, CA; Costa Mesa, CA; Garden Grove, CA; Huntington Beach, CA; Irvine, CA; La Palma, CA; Newport Coast, CA; Rossmoor, CA

National Provider Directory

National Provider Directory
Tax ID family
John P Anderson MD Russell M Perry MD and Mark a Sharzer AMC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1467567511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 646",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906800646",
            "telephone_number": "562-809-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 WEST ORANGE AVE.",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92804",
            "telephone_number": "714-229-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN P ANDERSON MD RUSSELL M PERRY MD AND MARK A SHARZER MD A MED CRP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "SHARZER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "714-229-4060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.