NPIMap

Individual provider Active NPI

Royal Dean, M.D.

  • General Practice Physician
  • Simi Valley, CA
National Provider Identifier
1417976945
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G063880 Issued in CA
Practice address
1687 Erringer Rd Ste 217
Simi Valley, CA 93065-6510
Phone
(805) 577-0059
NPI assigned
Jul 18, 2006
Last updated
Mar 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G063880 CA Primary

Addresses

Primary practice location

1687 Erringer Rd Ste 217
Simi Valley, CA 93065-6510

Mailing address

1129 Red Tail Way
Simi Valley, CA 93065-7232
Phone (805) 522-6222

Other identifiers 1

IdentifierTypeStateIssuer
110237972OtherCARAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000098 CA Practitioner - General Practice 7810182110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Oral Roberts University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1129 Red Tail Way
Simi Valley, CA 93065-7232
Phone (805) 577-1515

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions23
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63880CAMDGeneral Practice Dentistry
G063880CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Royal E Dean MD Medical Corporation General Practice CurrentSince Aug 23, 2010 Accepting new patients
Simi Valley Hospital and Health Care Services Past Accepting new patients

Locations

1129 Red Tail Way
Simi Valley, CA 93065
Phone (805) 558-8343

1687 Erringer Rd
Ste 217
Simi Valley, CA 93065
Phone (281) 505-5680

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1417976945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 RED TAIL WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930657232",
            "telephone_number": "805-522-6222",
            "fax_number": "805-577-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 ERRINGER RD STE 217",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930656510",
            "telephone_number": "805-577-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "ROYAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G063880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110237972",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.