JACK MARTIN ANDERSON M.D.
NPI 1609948223
Pediatrics - Neonatal-Perinatal Medicine in San Diego, CA

Q: What is Jack Anderson's NPI number?

The NPI number for Jack Anderson is 1609948223. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Q: What is Jack Anderson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for Jack Anderson was last updated on December 11, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2006PECOS Enrolled

3003 HEALTH CENTER DR, SAN DIEGO, CA 92123(858) 939-4185 Get Directions Write a Review

NPPES record last updated: December 11, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack Martin Anderson M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK MARTIN ANDERSON M.D. (NPI 1609948223) is an individual neonatal-perinatal medicine provider in San Diego, California, licensed in California (G60266) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609948223

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameJACK MARTIN ANDERSONCredential: M.D.

Location Address3003 HEALTH CENTER DRSan Diego, CA 92123-2700

Mailing Address8555 Aero Drive, Suite 104San Diego, CA 92123 · (858) 384-7828 · Fax (858) 598-6344

Phone(858) 939-4185

Sole ProprietorNo

Enumeration DateNovember 15, 2006

Last NPPES UpdateDecember 11, 2013

✔ NPI 1609948223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in CA · G60266

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

Also ListedPediatricsTaxonomy 208000000X · License G60266 (CA)

3003 HEALTH CENTER DR, San Diego, CA 92123

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Other Identifiers 1

Medicaid00G602660CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Martin Anderson M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMY CROWLEY

Registered Nurse (Neonatal Intensive Care)