Individual provider Active NPI

Steven John Anderson, M.D.

  • Pediatric Sports Medicine Physician
  • Seattle, WA
National Provider Identifier
1982752069
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X
License
MD00021245 Issued in WA
Practice address
3216 NE 45TH Place
Suite 304
Seattle, WA 98105-4093
Phone
(206) 523-1422
Fax
(206) 523-3101
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Sports Medicine Physician 2080S0010X MD00021245 WA Primary

Addresses

Primary practice location

3216 NE 45TH Place
Suite 304
Seattle, WA 98105-4093

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20120420000471 WA Practitioner - Sports Medicine 9638330434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
University of Washington School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Opa Ortho PLLCGroup PAC ID 7012371305, 42 clinicians

Practice addresses (Care Compare)

3216 NE 45TH PL
Suite 304
Seattle, WA 98105-4028
Phone (206) 523-1422

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Sports Medicine CurrentSince Jan 1, 2013 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Opa Ortho PLLC CurrentSince Oct 1, 2023 Accepting new patients
Proliance Surgeons Inc., P.S. CurrentSince Jan 1, 2013 Accepting new patients

Locations

20700 Bond Rd NE
Ste 103
Poulsbo, WA 98370
Phone (206) 799-2132

900 Terry Ave
Ste 100
Seattle, WA 98104
Phone (206) 694-6665

601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

601 Broadway
#700
Seattle, WA 98122
Phone (206) 622-2600

3216 NE 45th Pl
Ste 304
Seattle, WA 98105
Phone (206) 523-1422

601 Broadway
Fl 7
Seattle, WA 98122
Phone (206) 518-6311

Interoperability endpoints

  • Direct secure messaging: sanderson1041018@wm.providencedirect.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1982752069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PLACE",
            "address_2": "SUITE 304",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054093",
            "telephone_number": "206-523-1422",
            "fax_number": "206-523-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "WA",
            "license": "MD00021245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.