Organization Active NPI

Ronald L Anderson, MD PC

  • Ophthalmology Physician
  • Washington, DC
National Provider Identifier
1841520624
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RONALD L ANDERSON, MD PC
Practice address
2041 Martin Luther King Jr Ave SE Ste 102
Washington, DC 20020-7033
Phone
(202) 889-5700
NPI assigned
Dec 30, 2009
Last updated
Sep 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Montez Anderson
Title
Office Manager
Phone
(202) 889-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

2041 Martin Luther King Jr Ave SE Ste 102
Washington, DC 20020-7033

Mailing address

2041 Martin Luther King Jr Ave SE Ste 102
Washington, DC 20020-7033

Other practice location 1

106 Irving St NW Ste 214
Washington, DC 20010-2993
Phone (301) 442-9061

Other identifiers 2

IdentifierTypeStateIssuer
021821600MedicaidDC
81590001OtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100209000019 DC Part B Supplier - Clinic/Group Practice 4284777533 Receives reassigned benefits from 3 practitioners
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

106 Irving St NW
#214S
Washington, DC 20010

106 Irving St NW
Ste 214
Washington, DC 20010
Phone (301) 442-9061

106 Irving St NW
Ste 214S
Washington, DC 20010

2041 Martin Luther King Jr Ave SE
Ste 102
Washington, DC 20020
Phone (202) 889-5700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20012/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1841520624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE STE 102",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 MARTIN LUTHER KING JR AVE SE STE 102",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200207033",
            "telephone_number": "202-889-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Irving St NW Ste 214",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102993",
            "country_code": "US",
            "telephone_number": "301-442-9061",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RONALD L ANDERSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MONTEZ",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "202-889-5700"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021821600",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81590001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.