NPIMap

Individual provider Active NPI

Jacob Anderson, MD

  • Diagnostic Radiology Physician
  • Madison, WI
National Provider Identifier
1659830669
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
75340-20 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-3440
Phone
(608) 263-9729
Fax
(608) 263-0682
NPI assigned
Mar 19, 2019
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 75340-20 WI Primary

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-3440

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230720000095 WI Practitioner - Diagnostic Radiology 5193058279 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians
Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians

Practice addresses (Care Compare)

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

800 Compassion Way
Dodgeville, WI 53533-1956
Phone (608) 935-2711

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc CurrentSince Aug 1, 2024 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Group Health Cooperative of South Central Wisconsin CurrentSince Jul 1, 2024 Accepting new patients
Fort Healthcare Inc CurrentSince Jul 1, 2024 Accepting new patients
Fort Healthcare Inc Current Accepting new patients
Dean Health Systems, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 19, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Jun 19, 2023 Accepting new patients
Fort Healthcare, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Specialists in Medical Imaging SC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

800 Clay St
Darlington, WI 53530
Phone (608) 776-4466

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

675 W Washington Ave
Madison, WI 53703
Phone (608) 257-5178

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: janderson746232@direct.unitypoint.org

Organizations & group practices 12

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 9

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1659830669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537923440",
            "telephone_number": "608-263-9729",
            "fax_number": "608-263-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "75340-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.