Alan E. Williamson, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

G68558 Issued in CA

Practice address

39300 Bob Hope Dr
Bannan 1101
Rancho Mirage, CA 92270-3203

Phone

(760) 341-7088

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2025 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487670220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39300 BOB HOPE DR",
            "address_2": "BANNAN 1101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703203",
            "telephone_number": "760-341-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39300 BOB HOPE DR",
            "address_2": "BANNAN 1101",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703203",
            "telephone_number": "760-341-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "ALAN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G68558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G685580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wilcare Medicare Group, Inc.
• William a Stellar MD Inc
• William R Page MD Inc
• William S. Longfellow, M.D., Inc.
• Kiyanna Marie Williams, MD
• George William Wilson, M.D.
• Joseph W Wilson Jr., MD
• Mark D Wilson, M.D.
• Sherry Lee Wilson, PA-C
• McKelle S Wilwand, PA-C

• Vascular Surgery Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Vascular Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.