Dr Shane Blake Anderson, DO - Medicare Diagnostic Radiology in Fort Sam Houston, TX

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Dr Shane Blake Anderson, DO is a medicare enrolled "Nuclear Medicine" physician in Fort Sam Houston, Texas. He graduated from medical school in 2002 and has 22 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Mountain Medical Physician Specialists Pc and his current practice location is 3551 Roger Brooke Dr, Brooke Army Medical Center, Fort Sam Houston, Texas. You can reach out to his office (for appointments etc.) via phone at (210) 916-4062.

Dr Shane Blake Anderson is licensed to practice in Utah (license number 328507-1204) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1144208661.

Contact Information

Dr Shane Blake Anderson, DO
3551 Roger Brooke Dr, Brooke Army Medical Center,
Fort Sam Houston, TX 78234-4504
(210) 916-4062
Not Available

Map and Direction




Physician's Profile

Full NameDr Shane Blake Anderson
GenderMale
SpecialityDiagnostic Radiology
Experience22 Years
Location3551 Roger Brooke Dr, Fort Sam Houston, Texas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Shane Blake Anderson graduated from medical school in 2002
  NPI Data:
  • NPI Number: 1144208661
  • Provider Enumeration Date: 01/04/2006
  • Last Update Date: 12/19/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8426322942
  • Enrollment ID: I20170922000341

Medical Identifiers

Medical identifiers for Dr Shane Blake Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1144208661NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 378 (Nebraska)Secondary
207U00000XNuclear Medicine 328507-1204 (Utah)Primary
207UN0902XNuclear Medicine - Nuclear Imaging & Therapy 378 (Nebraska)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Davis Hospital And Medical CenterLayton, UTHospital
Moab Regional HospitalMoab, UTHospital
Jordan Valley Medical CenterWest jordan, UTHospital
Salt Lake Regional Medical CenterSalt lake city, UTHospital
Kane County HospitalKanab, UTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mountain Medical Physician Specialists Pc529463940732

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Shane Blake Anderson allows following entities to bill medicare on his behalf.
Entity NameMountain Medical Physician Specialists Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720035520
PECOS PAC ID: 5294639407
Enrollment ID: O20031120000357
Entity NameWasatch Imaging Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1679645139
PECOS PAC ID: 7012949522
Enrollment ID: O20050906000837
Entity NameUniversity Of Utah Adult Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114321981
PECOS PAC ID: 0941525273
Enrollment ID: O20150209001683

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shane Blake Anderson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Shane Blake Anderson, DO
3551 Roger Brooke Dr, Brooke Army Medical Center,
Fort Sam Houston, TX 78234

Ph: () -		Dr Shane Blake Anderson, DO
3551 Roger Brooke Dr, Brooke Army Medical Center,
Fort Sam Houston, TX 78234-4504

Ph: (210) 916-4062

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.