JACK ANDERSON MD
NPI 1992737522
Internal Medicine in Appleton, WI

Q: What is Jack Anderson's NPI number?

The NPI number for Jack Anderson is 1992737522. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Q: What is Jack Anderson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Anderson was last updated on November 16, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 July 06, 2006PECOS Enrolled

2500 E CAPITOL DR, APPLETON, WI 54911(920) 731-5811(920) 738-6293 Get Directions Write a Review

NPPES record last updated: November 16, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jack Anderson Md NPPES

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

JACK ANDERSON MD (NPI 1992737522) is an individual internal medicine provider in Appleton, Wisconsin, licensed in Wisconsin (26238-020) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992737522

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameJACK ANDERSONCredential: MD

Location Address2500 E CAPITOL DRAppleton, WI 54911-8735

Mailing AddressPo Box 8003Appleton, WI 54912-8003 · (920) 996-3298

Phone(920) 731-5811

Fax(920) 738-6293

Sole ProprietorNo

Enumeration DateJuly 6, 2006

Last NPPES UpdateNovember 16, 2011

✔ NPI 1992737522 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WI · 26238-020

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2500 E CAPITOL DR, Appleton, WI 54911

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Other Identifiers 5

Other711290042WI · Medicare Ptan

Medicaid30608500WI

Other450030618WI · Medicare Ptan

Other110048483Rr Medicare

Medicare UPINA02296

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 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54911 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

17 suppliers56 claims142 services$5.97 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers13 claims15 services$0.98 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier12 claims350 services$1.62 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier25 claims12,502 services$0.31 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

ELIZABETH A BARTHEL

Nurse Practitioner (Family)