Individual provider Active NPI

Jay Marcus Anderson, D.O.

  • Internal Medicine Physician
  • Rochester, MN
National Provider Identifier
1902246465
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
63242 Issued in MN
Practice address
201 9TH St SE
Rochester, MN 55904-6768
Phone
(507) 288-3443
NPI assigned
Jun 28, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101020750 MI
Internal Medicine Physician 207R00000X 63242 MN Primary

Addresses

Primary practice location

201 9TH St SE
Rochester, MN 55904-6768

Mailing address

210 9TH St SE
Rochester, MN 55904-6756
Phone (507) 288-3443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160726001387 MI Practitioner - Internal Medicine 3476846668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Michigan PCGroup PAC ID 9931347879, 42 clinicians

Practice addresses (Care Compare)

850 W Baraga Ave
Marquette, MI 49855-4550
Phone (906) 449-3747

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group, Michigan, PC Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
McLaren Northern Michigan CurrentSince Apr 1, 2023 Accepting new patients
McLaren Northern Michigan CurrentSince Apr 1, 2023 Accepting new patients
DLP Marquette General Hospital LLC Past Accepting new patients
McLaren Northern Michigan Past Accepting new patients

Locations

850 W Baraga Ave
Marquette, MI 49855
Phone (906) 225-3595

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

560 W Mitchell St
Ste 300
Petoskey, MI 49770
Phone (231) 487-2460

Interoperability endpoints

  • Direct secure messaging: janderson395486@direct.hfhs.org

Organizations & group practices 5

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": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516579200000",
    "number": "1902246465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046768",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JAY",
        "middle_name": "MARCUS",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2018-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101020750",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "63242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.