NPIMap

Individual provider Active NPI

John G Anderson, MD

  • Orthopaedic Foot and Ankle Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1700874294
Registry record updated Jan 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
4301070607 Issued in MI
Practice address
1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone
(616) 459-7101
Fax
(616) 464-6170
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X 4301070607 MI Primary

Addresses

Primary practice location

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525

Mailing address

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone (616) 459-7101

Other identifiers 3

IdentifierTypeStateIssuer
200030127OtherRAILROAD MEDICARE
442790001OtherADMINISTAR
3380119MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080903000101 MI Practitioner - Orthopedic Surgery 7517934383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopaedic Associates of Grand Rapids PC 86 clinicians
Center for Physical Rehabilitation Inc 352 clinicians
Center for Physical Rehabilitation and Therapy LP 365 clinicians
Metropolitan Hospital 421 clinicians

Practice addresses (Care Compare)

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

1840 Wealthy St SE
Grand Rapids, MI 49506-2921
Phone (616) 774-7444

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

781 36TH St SE
Metro HLTH Comm Clinic
Wyoming, MI 49548-2319
Phone (616) 252-4100

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301070607MIMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Sep 10, 2017 Accepting new patients
Orthopaedic Associates of Grand Rapids, PC CurrentSince Aug 1, 1997 Accepting new patients
Orthopaedic Associates of Grand Rapids PC Foot and Ankle Surgery CurrentSince Aug 1, 1997 Accepting new patients
Metropolitan Hospital CurrentSince Sep 10, 2017 Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: john.anderson.p1@direct.oam.nextgenshare.com
  • Direct secure messaging: janderson128@direct.metrohealth.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359504000000",
    "number": "1700874294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525",
            "telephone_number": "616-459-7101",
            "fax_number": "616-464-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2013-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "MI",
            "license": "4301070607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200030127",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR",
            "identifier": "442790001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3380119",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.