Individual provider Active NPI

William Dean Anderson Jr., MD

  • Facial Plastic Surgery Physician
  • Turlock, CA
National Provider Identifier
1366490724
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
G83962 Issued in CA
Practice address
1117 E Main St Ste a
Turlock, CA 95380-3443
Phone
(209) 417-1757
Fax
(209) 417-1756
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X G83962 CA
Facial Plastic Surgery Physician 207YS0123X G83962 CA Primary

Addresses

Primary practice location

1117 E Main St Ste a
Turlock, CA 95380-3443

Mailing address

1117 E Main St Ste a
Turlock, CA 95380-3443
Phone (209) 417-1757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000591 CA Practitioner - Otolaryngology 3971526575 Practice locations: Turlock, CA

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1117 E Main St
Suite a
Turlock, CA 95380-3443
Phone (209) 417-1757

Hospital & facility affiliations

  • Emanuel Medical Center Hospital, Turlock, CA, CCN 050179

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision45
Removal of skin lesions124
Removal or shaving of skin growth50
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G83962CAMDFacial Plastic Surgery Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1366490724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST STE A",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803443",
            "telephone_number": "209-417-1757",
            "fax_number": "209-417-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 E MAIN ST STE A",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953803443",
            "telephone_number": "209-417-1757",
            "fax_number": "209-417-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "WILLIAM",
        "middle_name": "DEAN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "G83962",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "G83962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Turlock, CA

Sources for this page

Verify at the official NPI Registry.