NPIMap

Individual provider Active NPI

Joshua Alan Anderson, MS, PA-C

  • Medical Physician Assistant
  • Ellicott City, MD
National Provider Identifier
1891005484
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004351 Issued in MD
Practice address
4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone
(410) 997-5191
Fax
(410) 997-7957
NPI assigned
Oct 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0004351 MD Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766

Mailing address

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7766
Phone (410) 997-5191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110602000087 MD Practitioner - Physician Assistant 2466639398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, 730 clinicians
Lifebridge Medical Associates LLCGroup PAC ID 0446470165, 18 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7749
Phone (443) 393-3788

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • Adoration Home Health Baltimore Home health agency, Baltimore, MD, CCN 217134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004351MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
St Paul Place Specialists Inc Past Accepting new patients

Organizations & group practices 12

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 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1891005484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-5191",
            "fax_number": "410-997-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 201",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "410-997-5191",
            "fax_number": "410-997-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOSHUA",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-15",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.