NPIMap

Individual provider Active NPI

Samuel R Anderson, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Columbus, OH
National Provider Identifier
1902883135
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35-08-0575 Issued in OH
Practice address
4895 Olentangy River Rd
Suite 100
Columbus, OH 43214-1926
Phone
(614) 457-7732
Fax
(614) 457-4346
NPI assigned
Dec 29, 2005
Last updated
Aug 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35-08-0575 OH Primary

Addresses

Primary practice location

4895 Olentangy River Rd
Suite 100
Columbus, OH 43214-1926

Mailing address

4895 Olentangy River Rd
Suite 100
Columbus, OH 43214-1926
Phone (614) 457-7732

Other identifiers 1

IdentifierTypeStateIssuer
2327486MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20041103000052 OH Practitioner - Endocrinology 5092777813 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Cincinnati College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knox Community HospitalGroup PAC ID 1153301833, 117 clinicians

Practice addresses (Care Compare)

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.04 of 100Reported as group
Quality
85.5
Improvement activities
40
Cost
83.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Telecare, PLLC CurrentSince Apr 22, 2024 Accepting new patients
Knox Community Hospital CurrentSince Apr 1, 2025 Accepting new patients
Knox Community Hospital CurrentSince Apr 1, 2025 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2002 Accepting new patients
Central Ohio Primary Care Physicians Inc Endocrinology, Diabetes & Metabolism Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Jul 1, 2002 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3433 Agler Rd
Columbus, OH 43219
Phone (614) 453-1065

4825 Knightsbridge Blvd
Ste A
Columbus, OH 43214
Phone (614) 459-0216

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

4895 Olentangy River Rd
Ste 100
Columbus, OH 43214
Phone (614) 457-7732

500 Thomas Ln
Ste 3G
Columbus, OH 43214
Phone (614) 457-7732

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

291 W Schrock Rd
Ste B
Westerville, OH 43081
Phone (614) 776-5750

570 Polaris Pkwy
Ste 250
Westerville, OH 43082
Phone (614) 459-0216

Interoperability endpoints

  • Direct secure messaging: samuelanderson@kch.allscriptsdirect.net
  • Direct secure messaging: sanderson19190@copcp.medicity.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1902883135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141926",
            "telephone_number": "614-457-7732",
            "fax_number": "614-457-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4895 OLENTANGY RIVER RD",
            "address_2": "SUITE 100",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141926",
            "telephone_number": "614-457-7732",
            "fax_number": "614-457-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMUEL",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "OH",
            "license": "35-08-0575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2327486",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.