DAVID J. ANDERSON (MD) – Neonatal-Perinatal Medicine Physician, NPI 1063590123

DAVID J. ANDERSON (MD) is a healthcare provider. based in Oakland, California. specializing in PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. A80948 (CA). The NPI Number for DAVID J. ANDERSON (MD) is 1063590123

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DAVID J. ANDERSON (MD)
NPI
1063590123
Phone
(510) 625-6262
Address
1800 HARRISON ST FL 7
Enumeration Date
2 November 2006
Last Update Date
22 December 2021

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF PENNSYLVANIA
Secondary Phone
2094762000
Graduation Year
1997 (29 years ago)
PAC ID
9234022856
Group Practice PAC ID
8921910225
Professional Enrollment ID
I20040205001284
Address ID
CA952103377ST7373XLANE300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,386 PEDIATRIC MEDICINE in CA

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Provider Addresses for DAVID J. ANDERSON (MD)

  • Harrison Street, Chinatown, Oakland, Alameda County, California, 94607, United States

    OAKLAND, CA 946123466

    Phone: (510) 625-6262

    Type: Mailing

  • 45B, 1425, South Main Street, Walnut Creek, Contra Costa County, California, 94596, United States

    WALNUT CREEK, CA 945965318

    Phone: (925) 295-4000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-02-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040205001284IPediatric MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94612)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921910225View full group profile
NameSpecialtyState
Emergency MedicineDC
-CA
N E U R O S U R G E R YMA
Internal MedicineCA
Nurse PractitionerCA
Internal MedicineCA
-MA
Emergency MedicineCA
-CA
Internal MedicineNY

Reviews

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Frequently asked questions

How do I look up DAVID J. ANDERSON (MD) by NPI?
Use NPI 1063590123 when you need to reference DAVID J. ANDERSON (MD) in forms, claims, or directories.
Is DAVID J. ANDERSON (MD) currently active in the NPI registry?
CMS-published data lists DAVID J. ANDERSON (MD) as an active registrant.
What field does DAVID J. ANDERSON (MD) work in?
You can think of DAVID J. ANDERSON (MD) as practicing within Neonatal-Perinatal Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for DAVID J. ANDERSON (MD)?
We surface Oakland, California for DAVID J. ANDERSON (MD) based on available NPPES addresses.
What if Oakland, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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