Lisa Nicole Anderson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14242949-1205 Issued in UT

Practice address

1055 N 300 W Ste 101
Provo, UT 84604-3381

Phone

(801) 852-3460

Fax

(801) 852-3459

NPI assigned

Jun 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

General Surgery

Education

Texas a & M University System, HSC, College of Medicine, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: lisa.anderson@txo.ikm.direct-ci.com

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.

• Utah Surgical Associates, Inc.

  • Specialist
  • Provo, UT
  • NPI 1851450720
  Medicare reassignment NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Dallas, TX
  • NPI 1003083445

  Surgery

  NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • El Paso, TX
  • NPI 1811944101

  Surgery

  NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Pearland, TX
  • NPI 1912174350

  Surgery

  NPD
• Granite Peaks Gi, LLC

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1689872897
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Hospital at Medical City Dallas Subsidiary LP

  dba Medical City Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  dba Medical City Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1992226021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N UNIVERSITY AVE STE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046695",
            "telephone_number": "801-374-9625",
            "fax_number": "801-374-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W STE 101",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043381",
            "telephone_number": "801-852-3460",
            "fax_number": "801-852-3459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "14242949-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerstin M Anderson, AUDIOLOGIST
• Kirk R Anderson, MD
• Kristi Kay Anderson, FNP-C
• Laina Anderson
• Laurel Leah Anderson, SSW
• Matthew David Anderson
• Michael Anderson, PA
• Michelle Renee Anderson
• Nathan Edward Anderson, D.O.
• Nichole Ashley Anderson

• Surgery Physician in Provo, UT
• Providers in Provo, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.