Ross E Anderson, MD
Individual provider Active NPI Family Medicine Physician · Shoreview, MN
NPI 1619938420 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1619938420
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 20844 (MN)
- Practice address
- 4194 Lexington Ave N
Shoreview, MN 55126-6106 - Phone
- (651) 483-5461
- Fax
- (651) 483-2155
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20844 | MN | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20844 | MN | Yes |
Addresses
Primary practice location
4194 Lexington Ave N
Shoreview, MN 55126-6106
Mailing address
PO Box 43
Mr 10809
Minneapolis, MN 55440-0043
Phone (612) 262-4813
Other providers in Shoreview, MN
- Barbara Eileen Anderson
- Christian Peter Anderson
- Janet Marie Anderson
- Kathryn Palkki Anderson
- Payton Anderson
- Sydney Rae Anderson
- Kyle Fredrick Anstett
- Carla Kahale Anton
- Ardenview
- Ataraxia Mental Health PLCC
All providers in Shoreview, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.