Individual provider Active NPI

Michael Jeremy Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • Iowa City, IA
National Provider Identifier
1770722951
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D-121126 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-2633
Fax
(319) 356-2940
NPI assigned
Feb 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X D-121126 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-2633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090513000265 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5597814061 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waverly Health CenterGroup PAC ID 8820996762, 44 clinicians
Mason City Ambulatory Surgery Center, LLCGroup PAC ID 8123037140, 14 clinicians

Practice addresses (Care Compare)

312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-4120

990 4TH St SW
Mason City Ambulatory CT LLC
Mason City, IA 50401-2861
Phone (641) 494-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-121126IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
M & M Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Mason City Ambulatory Surgery Center, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 6, 2023 Accepting new patients
Waverly Health Center Nurse Anesthetist, Certified Registered CurrentSince Sep 27, 2022 Accepting new patients
Waverly Health Center CurrentSince Sep 27, 2022 Accepting new patients
Mason City Ambulatory Surgery Center, LLC Past Accepting new patients

Locations

2963 Northgate Dr
Iowa City, IA 52245
Phone (319) 248-1500

990 4th St SW
Mason City, IA 50401
Phone (641) 494-2000

1750 Jordan St
North Liberty, IA 52317
Phone (319) 569-3444

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

1455 29th St
West Des Moines, IA 50266
Phone (515) 267-1800

1300 37th St
West Des Moines, IA 50266
Phone (515) 224-4711

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252540800000",
    "number": "1770722951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2633",
            "fax_number": "319-356-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-2633",
            "fax_number": "319-356-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHAEL",
        "middle_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D-121126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.