Active NPI
Carlos E Andersen, M.D.
- Specialist
- Concord, CA
National Provider Identifier
1477620128
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jan 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 00A295320
- Practice address
- 3301 Clayton Rd
Concord, CA 94519-2820 - Phone
- (925) 685-3020
- Fax
- (925) 685-5017
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 00A295320 | CA | Primary |
Addresses
Primary practice location
3301 Clayton Rd
Concord, CA 94519-2820
Mailing address
3301 Clayton Rd
Concord, CA 94519-2820
Phone (925) 685-3020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00A295320 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438300800000",
"number": "1477620128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 CLAYTON RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192820",
"telephone_number": "925-685-3020",
"fax_number": "925-685-5017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3301 CLAYTON RD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945192820",
"telephone_number": "925-685-3020",
"fax_number": "925-685-5017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "CARLOS",
"middle_name": "E",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2015-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "00A295320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.