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JACK RAYMOND ANDERSON
NPI 1881166775
Surgery in Cleveland, OH

Active since December 18, 2018PECOS EnrolledAccepts Medicare Assignment
1730 W 25TH ST, CLEVELAND, OH 44113(216) 903-7287 Get Directions Write a Review

NPPES record last updated: December 18, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Raymond Anderson NPPES

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

JACK RAYMOND ANDERSON (NPI 1881166775) is an individual surgery provider in Cleveland, Ohio, licensed in Ohio (50.005645RX) and active in the NPI registry since December 2018. He is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1881166775
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJACK RAYMOND ANDERSON
Location Address1730 W 25TH STCleveland, OH 44113-3108
Mailing Address1730 W 25th StCleveland, OH 44113-3108
Phone(216) 903-7287
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateDecember 18, 2018
✔ NPI 1881166775 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in OH · 50.005645RX
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1730 W 25TH ST, Cleveland, OH 44113
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Raymond Anderson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193061505
PECOS Enrollment IDI20190107000348
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360087
Location1730 West 25th StreetCleveland, OH 44113 · Cuyahoga County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44113 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.10 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

MS. JANICE LOUISE TODD PA-C
Physician Assistant (Medical)
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 696-4300
BRUCE D LONG, M.D.
Internal Medicine (Rheumatology)
1730 W 25TH ST, 1200
CLEVELAND, OH 44113
Cuyahoga County (216) 363-2402
LUTHERAN HOSPITAL
Psychiatric Unit
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 696-4300
KATHLEEN M BAKER CNP
Nurse Practitioner
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 696-4300
MIGUEL ANGEL MELENDEZ CNP
Nurse Practitioner (Family)
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 363-2292
EMMA TILOW APRN.CNP
Nurse Practitioner (Psychiatric/Mental Health)
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 696-4300
ANITA MILICIA
Social Worker
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 363-2122
LESLIE SHRAMKO RD
Dietitian, Registered
1730 W 25TH ST
CLEVELAND, OH 44113
Cuyahoga County (216) 696-4300

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 Jack Anderson's NPI number?

The NPI number for Jack Anderson is 1881166775. It was assigned to this individual provider in the NPPES registry on December 18, 2018.

Where is Jack Anderson located?

Jack Anderson practices at 1730 W 25th St, Cleveland, OH 44113. The listed phone number is (216) 903-7287.

What is Jack Anderson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Jack Anderson enrolled in Medicare?

Yes. Jack Anderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jack Anderson affiliated with any hospitals?

According to CMS data, Jack Anderson is affiliated with Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Jack Anderson was last updated on December 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.