David J Anderson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G41509 Issued in CA

Practice address

365 Hawthorne Ave
#201
Oakland, CA 94609-3107

Phone

(510) 452-1345

Fax

(510) 452-1102

NPI assigned

Jul 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• David Jarvis Anderson Other name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• KND Development 59 LLC

  • Hospitalist Physician
  • Santa Ana, CA
  • NPI 1740519081
  Medicare reassignment NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • San Leandro, CA
  • NPI 1235468562
  NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Broken Arrow, OK
  • NPI 1922950823
  NPD

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1780613380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "#201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94609",
            "telephone_number": "510-452-1345",
            "fax_number": "510-452-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HAWTHORNE AVE",
            "address_2": "#201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093107",
            "telephone_number": "510-452-1345",
            "fax_number": "510-452-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G41509",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "G41509",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G41509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "ANDERSON",
            "middle_name": "JARVIS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carljuan Anthony Anderson III
• Carrie F. Anderson, M.S.
• Charles Anderson
• Danikalynn Anderson
• Dante Saadiq Anderson
• Destiny S Anderson
• Dionne Anderson
• Elizabeth T. Anderson, MD
• Erik Sorem Anderson, M.D.
• Evelyn Maria Anderson

• Cardiovascular Disease Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.