Active NPI
Robert Louis Anderson, M.D.
- Ophthalmology Physician
- Santa Rosa, CA
National Provider Identifier
1801874144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G49374
- Practice address
- 1017 2ND St
Santa Rosa, CA 95404-6608 - Phone
- (707) 546-9800
- Fax
- (707) 546-4112
- NPI assigned
- Jan 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G49374 | CA | Primary |
Addresses
Primary practice location
1017 2ND St
Santa Rosa, CA 95404-6608
Mailing address
3536 Mendocino Ave
Ste 200
Santa Rosa, CA 95403-3634
Phone (707) 546-9800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G493740 | Medicaid | CA | |
| P01035543 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Past | Accepting new patients | |
| Sutter Bay Hospitals | Past | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| SRM Alliance Hospital Services | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Brea, CA
- NPI 1871607762
-
- Skilled Nursing Facility
- Petaluma, CA
- NPI 1770703886
-
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1134152549
-
- General Acute Care Hospital
- Santa Rosa, CA
- NPI 1740413798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340150400000",
"number": "1801874144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3536 MENDOCINO AVE",
"address_2": "STE 200",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954033634",
"telephone_number": "707-546-9800",
"fax_number": "707-546-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 2ND ST",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954046608",
"telephone_number": "707-546-9800",
"fax_number": "707-546-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ROBERT",
"middle_name": "LOUIS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2012-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "G49374",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G493740",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01035543",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.