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JACOB GLEN ANDERSON MD
NPI 1821733080
Pediatrics - Pediatric Rheumatology in Salt Lake City, UT

Active since May 02, 2022PECOS Enrolled
81 N MARIO CAPECCHI DR # 4B056, SALT LAKE CITY, UT 84113(801) 581-2121 Get Directions Write a Review

NPPES record last updated: March 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 19, 2025, May 2, 2022 (2 updates tracked since 2022).

About Jacob Glen Anderson Md NPPES

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

JACOB GLEN ANDERSON MD (NPI 1821733080) is an individual pediatric rheumatology provider in Salt Lake City, Utah, licensed in Utah (14210863-1205) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1821733080
Entity TypeIndividualMale
Primary Taxonomy2080P0216X
Provider Legal NameJACOB GLEN ANDERSONCredential: MD
Location Address81 N MARIO CAPECCHI DR # 4B056Salt Lake City, UT 84113-1125
Mailing Address81 N Mario Capecchi Dr # 4b056Salt Lake City, UT 84113-1125 · (801) 581-2121
Phone(801) 581-2121
Sole ProprietorNo
Enumeration DateMay 2, 2022
Last NPPES UpdateMarch 19, 20252 updates tracked since enumeration
NPPES CertifiedMarch 19, 2025
✔ NPI 1821733080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0216X
License✔ Licensed in UT · 14210863-1205
Definition
A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 390200000X
81 N MARIO CAPECCHI DR # 4B056, Salt Lake City, UT 84113
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Secondary Practice Location 1

Location 11919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-0945

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Glen Anderson Md 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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Anderson's NPI number?

The NPI number for Jacob Anderson is 1821733080. It was assigned to this individual provider in the NPPES registry on May 2, 2022.

Where is Jacob Anderson located?

Jacob Anderson practices at 81 N Mario Capecchi Dr # 4b056, Salt Lake City, UT 84113. The listed phone number is (801) 581-2121.

What is Jacob Anderson's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Rheumatology, with taxonomy code 2080P0216X.

Is Jacob Anderson enrolled in Medicare?

Yes. Jacob Anderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Anderson was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.