Individual provider Active NPI

Samuel Dee Anderson, M.D.

  • Anesthesiology Physician
  • San Ramon, CA
National Provider Identifier
1770708554
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A98380 Issued in CA
Practice address
2420 Camino Ramon
Ste. 270
San Ramon, CA 94583-4385
Phone
(925) 543-0141
Fax
(925) 543-0145
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A98380 CA
Anesthesiology Physician 207L00000X A98380 CA Primary
Anesthesiology Physician 207L00000X 232721 MA
Internal Medicine Physician 207R00000X 232721 MA

Addresses

Primary practice location

2420 Camino Ramon
Ste. 270
San Ramon, CA 94583-4385

Mailing address

PO Box 603484
Charlotte, NC 28260-3484
Phone (803) 765-1838

Other practice location 1

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CO, SC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20100816000882 CA Practitioner - Anesthesiology 1355475161 Reassigns benefits to 1 organization
I20200610003400 CO Practitioner - Anesthesiology 1355475161
I20210901003696 SC Practitioner - Anesthesiology 1355475161 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Southern California Keck School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1315 Roberts St
Camden, SC 29020-3737
Phone (803) 432-4311

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

  • Kershawhealth Hospital, Camden, SC, CCN 420048

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A98380CAMDAnesthesiology Physician
232721MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St. Francis Xavier Hospital, Inc. Internal Medicine CurrentSince Feb 3, 2023 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Feb 3, 2023 Accepting new patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince Sep 9, 2021 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Current Accepting new patients
Musc Community Physicians CurrentSince Aug 13, 2021 Accepting new patients
Musc Community Physicians Internal Medicine CurrentSince Aug 13, 2021 Accepting new patients
John Muir Trauma Physicians Billing Service Current Accepting new patients
John Muir Trauma Physicians Billing Service Anesthesiology CurrentSince Jul 19, 2010 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. Anesthesiology CurrentSince Feb 23, 2025 Accepting new patients

Locations

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1770708554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603484",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603484",
            "telephone_number": "803-765-1838",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 CAMINO RAMON",
            "address_2": "STE. 270",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834385",
            "telephone_number": "925-543-0141",
            "fax_number": "925-543-0145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMUEL",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A98380",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A98380",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "232721",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "232721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

Verify at the official NPI Registry.