Anthony J Anderson, MD
Individual provider Active NPI Family Medicine Physician · Burley, ID
NPI 1508021726 · NPPES record last updated Dec 30, 2010
Key facts
- NPI
- 1508021726
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- M-11018 (ID)
- Practice address
- 1501 Hiland Ave Ste a
Burley, ID 83318-2682 - Phone
- (208) 878-9432
- NPI assigned
- Jul 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anthony J Anderson MD and Assoc LLC
Ihc Health Services Inc
Practice addresses (Care Compare)
1404 Pomerelle Ave
Suite B
Burley, ID 83318-2013
Phone (208) 878-9432
1501 Hiland Ave
Burley, ID 83318-2688
Phone (208) 678-4444
Hospital & facility affiliations
- Cassia Regional Hospital
- Lost Rivers Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110317000069 | ID | Practitioner - Family Practice | 8527125798 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-11018 | ID | MD | Family Medicine Physician |
| 52403-020 | WI | MD | Family Medicine Physician |
| 2723 | WI | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anthony J Anderson MD & Assoc LLC | Family Medicine | Current |
Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| R Bret Campbell DO & Assoc LLC | Family Medicine | Current | Accepting new patients |
Locations
1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444
1404 Pomerelle Ave
Ste B
Burley, ID 83318
Phone (208) 878-9432
1501 Hiland Ave
Ste A
Burley, ID 83318
Phone (208) 878-9432
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 52403-020 | WI | |
| Family Medicine Physician | 207Q00000X | M-11018 | ID | Yes |
| Student in an Organized Health Care Education/Training Program | 390200000X | 2723 | WI |
Addresses
Primary practice location
1501 Hiland Ave Ste a
Burley, ID 83318-2682
Mailing address
1501 Hiland Ave Ste a
Burley, ID 83318-2682
Phone (208) 878-9432
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2723 | Other | WI | TEP |
Other providers in Burley, ID
- Tracy Ann Alvarez
- Ambulatory Surgery Center of Burley, LLC
- Ambulatory Surgery Center of Burley, LLC
- Amy J. Kauffman PLLC
- Eric Andersen
- Kasandra Jo Anderson
- Troy Michael Anderson
- Anesthesia West, PA
- Heather Tanner Anthon
- Anthony J Anderson MD & Assoc LLC
All providers in Burley, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.