Active NPI
Robert Clifton Anderson, M.D.
- Dermatology Physician
- Saint Paul, MN
National Provider Identifier
1831208685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 45910
- Practice address
- 3555 Willow Lake Blvd
Suite 240
Saint Paul, MN 55110-5131 - Phone
- (651) 770-0110
- Fax
- (651) 770-0134
- NPI assigned
- Aug 29, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 45910 | MN | Primary |
Addresses
Primary practice location
3555 Willow Lake Blvd
Suite 240
Saint Paul, MN 55110-5131
Mailing address
60 Plato Blvd E
Suite 270
Saint Paul, MN 55107-1827
Phone (651) 209-1600
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364G9AN | Other | MN | BLUE SHIELD |
| P00235749 | Other | MN | RAILROAD MEDICARE |
| 988178600 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050603000628 | MN | Practitioner - Dermatology | 8325081045 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Minnesota Medical School, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dermatology Consultants, PA
Practice addresses (Care Compare)
3555 Willow Lake Blvd
Suite 240
Vadnais Heights, MN 55110-5131
Phone (651) 770-0110
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.99 of 100
- Quality
- 61.48
- Promoting interoperability
- 93
- Improvement activities
- 40
- Cost
- 77.67
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 53 |
| Removal of skin lesions | 808 |
| Removal or shaving of skin growth | 24 |
| Skin biopsy | 276 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45910 | MN | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Consultants, PA | Dermatology | Current | Accepting new patients |
Locations
60 Plato Blvd E
Ste 270
Saint Paul, MN 55107
Phone (651) 209-1600
3555 Willow Lake Blvd
Ste 240
Vadnais Heights, MN 55110
Phone (651) 770-0110
576 Bielenberg Dr
Ste 200
Woodbury, MN 55125
Phone (651) 209-1600
Interoperability endpoints
- randerson@dermcons.encitedirect.com
Organizations & group practices 1
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 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1831208685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 PLATO BLVD E",
"address_2": "SUITE 270",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551071827",
"telephone_number": "651-209-1600",
"fax_number": "651-291-9169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 WILLOW LAKE BLVD",
"address_2": "SUITE 240",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551105131",
"telephone_number": "651-770-0110",
"fax_number": "651-770-0134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ROBERT",
"middle_name": "CLIFTON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MN",
"license": "45910",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "364G9AN",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00235749",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "988178600",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.
- 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.