Sophia Renee Anderson, MD
Individual provider Active NPI Plastic Surgery Physician · Indianapolis, IN
NPI 1891622692 · NPPES record last updated May 6, 2026
Key facts
- NPI
- 1891622692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Plastic Surgery Physician 208200000X
- License
- 208200000X (IN)
- Practice address
- 550 University Blvd
Indianapolis, IN 46202-5149 - Phone
- (707) 416-3766
- NPI assigned
- May 6, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208200000X | IN | MD | Plastic Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 208200000X | IN | Yes |
Addresses
Primary practice location
550 University Blvd
Indianapolis, IN 46202-5149
Mailing address
875 Meadowridge Dr
Fairfield, CA 94534-6623
Phone (707) 416-3766
Other providers in Indianapolis, IN
- Rebecca Taylor Anderson
- Rodney J Anderson
- Rosa M Anderson
- Ryan David Anderson
- Sierra Anderson
- Taletha Anderson
- Tomeika Rashel Anderson
- Trista Michelle Anderson
- Victoria A Anderson
- Wesley Luke Anderson
All providers in Indianapolis, IN · Plastic Surgery Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.