Active NPI
Robert Victor Anderson, DO
- Family Medicine Physician
- Port St Lucie, FL
National Provider Identifier
1851361737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS6082
- Practice address
- 11380 SW Village Parkway
Suite 100
Port St Lucie, FL 34987 - Phone
- (772) 301-6475
- Fax
- (772) 301-6480
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS6082 | FL | Primary |
Addresses
Primary practice location
11380 SW Village Parkway
Suite 100
Port St Lucie, FL 34987
Mailing address
11380 SW Village Parkway
Suite 100
Port St Lucie, FL 34987
Phone (772) 301-6475
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080127525 | Other | FL | RR MEDICARE |
| F01008 | Other | UPIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20240912001248 | FL | Order and Referring Only - Family Practice | 4082718929 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS6082 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitas Solutions Inc | Current | Accepting new patients | |
| Vitas Healthcare Corporation of Florida | Family Medicine | Past | Accepting new patients |
Locations
2179 SE Ocean Blvd
Stuart, FL 34996
Phone (772) 301-6475
Interoperability endpoints
- robert.anderson@hca4.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Miramar, FL
- NPI 1861666497
-
- Community Based Hospice Care Agency
- Tallahassee, FL
- NPI 1972555464
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768176000000",
"number": "1851361737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11380 SW VILLAGE PARKWAY",
"address_2": "SUITE 100",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34987",
"telephone_number": "772-301-6475",
"fax_number": "772-301-6480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11380 SW VILLAGE PARKWAY",
"address_2": "SUITE 100",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "34987",
"telephone_number": "772-301-6475",
"fax_number": "772-301-6480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ROBERT",
"middle_name": "VICTOR",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2026-01-12",
"certification_date": "2026-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS6082",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "080127525",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "F01008",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.