NPIMap

Individual provider Active NPI

David M Anderson, M.D

  • Orthopaedic Surgery Physician
  • Champaign, IL
National Provider Identifier
1821098013
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036116109 Issued in IL
Practice address
3101 Fields South Dr
Champaign, IL 61822-3743
Phone
(217) 366-1237
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036116109 IL Primary

Addresses

Primary practice location

3101 Fields South Dr
Champaign, IL 61822-3743

Mailing address

101 W University Ave
Champaign, IL 61820-3981
Phone (217) 366-1237

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address danderson286344@direct.myadvocateaurora.org
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address danderson220483@CarleHieDirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201202001235 IL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 9234190661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Rush Medical College of Rush University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

3101 Fields S Dr
Champaign, IL 61822-3743
Phone (217) 366-4000

Hospital & facility affiliations

  • Carle Foundation Hospital Hospital, Urbana, IL, CCN 140091
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC Orthopaedic Surgery CurrentSince Nov 1, 2020 Accepting new patients
Illinois Bone and Joint Institute LLC Orthopaedic Surgery CurrentSince Nov 1, 2020 Accepting new patients
Great Lakes Orthopedics and Sports Medicine, P.C. Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Great Lakes Orthopedics & Sports Medicine, PC Orthopaedic Surgery Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

27401 W State Route 22
Ste 125
Lk Barrington, IL 60010
Phone (847) 381-0388

Interoperability endpoints

  • Direct secure messaging: dandersonmd220483@carlehiedirect.net
  • Direct secure messaging: danderson220483@carlehiedirect.net
  • Direct secure messaging: danderson286344@direct.myadvocateaurora.org
  • FHIR API: https://api.platform.athenahealth.com/10531/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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 3

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1821098013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-366-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036116109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danderson286344@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "27401 W Highway 22 Ste 125",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600105934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "27401 W Highway 22 Ste 125",
            "city": "Barrington",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600105934",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danderson220483@CarleHieDirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3101 Fields South Dr",
            "city": "Champaign",
            "state": "IL",
            "country_code": "US",
            "postal_code": "618223743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.