Individual provider Active NPI

Stephen Anderson, M.D

  • Emergency Medicine Physician
  • Apple Valley, CA
National Provider Identifier
1659554194
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME154012 Issued in FL
Practice address
18300 US Highway 18
Apple Valley, CA 92307-2206
Phone
(760) 242-2311
NPI assigned
Dec 6, 2007
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A81689 CA
Emergency Medicine Physician 207P00000X ME154012 FL Primary

Addresses

Primary practice location

18300 US Highway 18
Apple Valley, CA 92307-2206

Mailing address

2100 Powell St
Ste 900
Emeryville, CA 94608-1826
Phone (510) 350-2664

Other identifiers 1

IdentifierTypeStateIssuer
00A816890MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150330001626 TN Practitioner - Emergency Medicine 7517951775 Reassigns benefits to 1 organization
I20220505001451 FL Practitioner - Emergency Medicine 7517951775 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A81689CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jan 16, 2015 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Apr 15, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jan 3, 2024 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jan 3, 2024 Accepting new patients
Anaheim Memorial Hospital Emergency Physicians Medical Group Emergency Medicine Past Accepting new patients
Columbia Emergency Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

205 Trinity Way
St Johns, FL 32259
Phone (904) 308-1255

436 Central Ave W
Jamestown, TN 38556
Phone (931) 752-5762

10820 Parkside Dr
Knoxville, TN 37934
Phone (865) 218-7011

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

7565 Dannaher Dr
Powell, TN 37849
Phone (865) 545-8000

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1659554194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "STE 900",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18300 US HIGHWAY 18",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072206",
            "telephone_number": "760-242-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STEPHEN",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A81689",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME154012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A816890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.