Individual provider Active NPI

Anthony D Sanders, MD

  • Otolaryngology Physician
  • Columbus, IN
National Provider Identifier
1689671885
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
01034467A Issued in IN
Practice address
1655 N Gladstone Ave
Ste E
Columbus, IN 47201-5380
Phone
(812) 376-3071
Fax
(812) 378-5721
NPI assigned
Jul 1, 2005
Last updated
Feb 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 01034467A IN Primary

Addresses

Primary practice location

1655 N Gladstone Ave
Ste E
Columbus, IN 47201-5380

Mailing address

1655 N Gladstone Ave
Ste E
Columbus, IN 47201-5380
Phone (812) 376-3071

Other identifiers 1

IdentifierTypeStateIssuer
100336270MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000956 IN Practitioner - Otolaryngology 4688772213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.75 of 100Reported as individual
Quality
77.51
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01034467AINMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Indiana ENT, LLC Otolaryngology CurrentSince Aug 1, 2001 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1655 N Gladstone Ave
Ste E
Columbus, IN 47201
Phone (812) 376-3071

701 E County Line Rd
Ste 209
Greenwood, IN 46143
Phone (317) 215-0177

Interoperability endpoints

  • Direct secure messaging: anthony.sanders.1@12832.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12832/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1689671885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 N GLADSTONE AVE",
            "address_2": "STE E",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015380",
            "telephone_number": "812-376-3071",
            "fax_number": "812-378-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 N GLADSTONE AVE",
            "address_2": "STE E",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015380",
            "telephone_number": "812-376-3071",
            "fax_number": "812-378-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ANTHONY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IN",
            "license": "01034467A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100336270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.