Individual provider Active NPI

Kristin Nicole Anderson, MD, MPH

  • Student in an Organized Health Care Education/Training Program
  • San Diego, CA
National Provider Identifier
1962732354
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone
(858) 361-7247
NPI assigned
Jan 6, 2010
Last updated
Jan 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
San Diego, CA 92161-0002

Mailing address

3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone (858) 361-7247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150930002680 CA Practitioner - Medical OncologyPractitioner - Hematology 2365750932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marin Cancer Care, Inc.Group PAC ID 1557542289, 13 clinicians

Practice addresses (Care Compare)

1350 S Eliseo Dr
Suite 200
Greenbrae, CA 94904-2018
Phone (415) 925-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marin Cancer Care Inc CurrentSince Sep 1, 2015 Accepting new patients
California Cancer Care, Inc. Past Accepting new patients

Locations

1350 S Eliseo Dr
Ste 200
Greenbrae, CA 94904
Phone (415) 925-5000

651 1st St W
Ste L
Sonoma, CA 95476
Phone (707) 935-5189

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262736000000",
    "number": "1962732354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-361-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-361-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.