Donald R. Anderson, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

036-147236 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-5349

Phone

(309) 655-2000

NPI assigned

Apr 13, 2007

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, IL, TX3 enrollments

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 3

Specialty

Diagnostic RadiologyAlso: Nuclear Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Cira Michigan PCGroup PAC ID 7113355264, 89 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067
• Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
• St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
• Saint James Hospital Hospital, Pontiac, IL, CCN 140161
• Osf Sacred Heart Medical Center Hospital, Danville, IL, CCN 140093

Medicare enrollment (NPD)

Enrolled

Credentials

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Illinois Radiological Associates, LTD.

  dba Central Illinois Radiological Associates

  • Diagnostic Radiology Physician
  • Peoria, IL
  • NPI 1538192828
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Cira Michigan PC

  • Diagnostic Radiology Physician
  • Escanaba, MI
  • NPI 1972141513

  IL

  Medicare reassignment Care Compare group NPD
• Integrated Imaging Consultants LLC

  • Diagnostic Radiology Physician
  • Park Ridge, IL
  • NPI 1700285335
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Specialists in Medical Imaging SC

  • Diagnostic Radiology Physician
  • Olympia Fields, IL
  • NPI 1841687951
  Medicare reassignment NPD
• Fred Smeltzer MD & Associates Inc

  dba Lake of the Ozarks Radiology

  • Diagnostic Radiology Physician
  • Osage Beach, MO
  • NPI 1639122286

  IL

  Medicare reassignment NPD
• Mercy Health System Corporation

  dba MHS Physician Services

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment NPD
• N W Indiana Radiology Services, PC

  • Body Imaging Physician
  • Merrillville, IN
  • NPI 1386693364
  Medicare reassignment NPD
• Palm Desert Radiology Medical Group, Inc

  dba Eisenhower Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Rancho Mirage, CA
  • NPI 1124079868

  IL

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD

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

• Osf Healthcare System

  dba OSF Sacred Heart Medical Center

  • General Acute Care Hospital
  • Danville, IL
  • NPI 1699288449
  Care Compare affiliation
• Ottawa Regional Hospital & Healthcare Center

  dba OSF Saint Elizabeth Medical Center

  • General Acute Care Hospital
  • Peru, IL
  • NPI 1588713440
  Care Compare affiliation
• Saint James Hospital

  dba Osf Saint James-John W Albrecht Medical Center

  • General Acute Care Hospital
  • Pontiac, IL
  • NPI 1407808090
  Care Compare affiliation
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  Care Compare affiliation

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1609090026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616375349",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11995 Singletree Ln Ste 500",
            "address_purpose": "LOCATION",
            "city": "Eden Prairie",
            "state": "MN",
            "postal_code": "553445349",
            "country_code": "US",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Methodist Hospital Southlake",
            "address_2": "8701 Broadway",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "46410",
            "country_code": "US",
            "telephone_number": "219-738-5565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DONALD",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01064057A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-147236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200866860",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Anderson, M.D.
• Christina Anderson, MD
• Clark Anderson, PA-C
• Dean Anderson, RN,C-FNP
• Debra Sue Anderson, PT
• Faith Anderson, LSW
• Gary Anderson, M.A.
• Lindsey Marie Anderson, PTA
• Madison Anderson
• Rachel Emily Anderson, OTR/L

• Diagnostic Radiology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Diagnostic Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.