Individual provider Active NPI

James Devin Anderson, DPM

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1770004525
Registry record updated Jul 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
650 E Indian School Rd
Phoenix, AZ 85012-1839
Phone
(601) 277-5551
NPI assigned
Jul 2, 2017
Last updated
Jul 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

650 E Indian School Rd
Phoenix, AZ 85012-1839

Mailing address

500 N Roosevelt Ave Unit 121
Chandler, AZ 85226-2657
Phone (808) 391-7514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210514001156 HI Practitioner - Podiatry 3375952724 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Western Un of HLTH Sciences, Col of Podiatric Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Permanente Medical Group IncGroup PAC ID 7618880667, 705 clinicians

Practice addresses (Care Compare)

3288 Moanalua Rd
Honolulu, HI 96819-1469
Phone (808) 432-0000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue14
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aloha Foot Centers, Inc. CurrentSince Feb 6, 2021 Accepting new patients
Hawaii Permanente Medical Group Inc CurrentSince Aug 28, 2023 Accepting new patients

Locations

3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205

711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312

407 Uluniu St
Ste 107
Kailua, HI 96734
Phone (808) 266-0066

46-001 Kamehameha Hwy
Ste 410
Kaneohe, HI 96744
Phone (808) 235-3696

Organizations & group practices 3

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 1

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": "1498953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498953600000",
    "number": "1770004525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N ROOSEVELT AVE UNIT 121",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262657",
            "telephone_number": "808-391-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "601-277-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JAMES",
        "middle_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-02",
        "last_updated": "2017-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.