Individual provider Active NPI

Robert Victor Anderson, DO

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1851361737
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS6082 Issued in FL
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

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
080127525OtherFLRR MEDICARE
F01008OtherUPIN

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912001248 FL Order and Referring Only - Family PracticePractitioner - Family Practice 4082718929

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS6082FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitas Solutions Inc CurrentSince Oct 1, 2020 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.