Individual provider Active NPI

Roger S. Andersen, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Casa Grande, AZ
National Provider Identifier
1821167313
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
1427 Issued in AZ
Practice address
1923 N Trekell Rd
Casa Grande, AZ 85222-1706
Phone
(520) 836-3412
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 1427 AZ Primary

Addresses

Primary practice location

1923 N Trekell Rd
Casa Grande, AZ 85222-1706

Mailing address

704 N Stewart
Mesa, AZ 85201-4641
Phone (480) 969-7972

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20061109000000 AZ Practitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 0941207708 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Robertson Chiropractic Inc CurrentSince Aug 12, 2014 Accepting new patients
Alpha Physical Therapy, Inc Past Accepting new patients
Pentz Health Services LLC Past Accepting new patients

Locations

4955 S Alma School Rd
Ste 10
Chandler, AZ 85248
Phone (480) 771-4400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1821167313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 N STEWART",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014641",
            "telephone_number": "480-969-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 N TREKELL RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "852221706",
            "telephone_number": "520-836-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "ROGER",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "AZ",
            "license": "1427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.