NPIMap

Individual provider Active NPI

Richard A Williams, M.D.

  • Specialist
  • San Dimas, CA
National Provider Identifier
1467457390
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A40188 Issued in CA
Practice address
1334 W Covina Blvd
Ste 102
San Dimas, CA 91773-3211
Phone
(909) 599-8677
Fax
(909) 592-0999
NPI assigned
Jun 16, 2005
Last updated
Nov 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A40188 CA Primary

Addresses

Primary practice location

1334 W Covina Blvd
Ste 102
San Dimas, CA 91773-3211

Mailing address

1334 W Covina Blvd
Ste 102
San Dimas, CA 91773-3211
Phone (909) 599-8677

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
I20040320000515 CA Practitioner - Obstetrics/Gynecology 5092606160 Reassigns benefits to 1 organization
Practice locations: San Dimas, CA

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1334 W Covina Blvd
Suite 102
San Dimas, CA 91773-3211

315 E Route 66
Suite 201
Glendora, CA 91740-6244
Phone (909) 599-8677

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Arcadia Hospital Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients
San Dimas Community Hospital, Inc. Past Accepting new patients
Chino Medical Group, Inc Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACCEAD/Endpoint/ACCEAD

Organizations & group practices 7

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 5

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1467457390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD",
            "address_2": "STE 102",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-599-8677",
            "fax_number": "909-592-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 W COVINA BLVD",
            "address_2": "STE 102",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733211",
            "telephone_number": "909-599-8677",
            "fax_number": "909-592-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A40188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

Verify at the official NPI Registry.