Individual provider Active NPI

Dean Loller Rider, MD

  • Gastroenterology Physician
  • San Francisco, CA
National Provider Identifier
1487759296
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
G401240 Issued in IL
Practice address
3580 California Street
Suite 302
San Francisco, CA 94118-1725
Phone
(415) 658-7497
Fax
(415) 929-1307
NPI assigned
Sep 14, 2006
Last updated
Jun 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X G401240 IL Primary

Addresses

Primary practice location

3580 California Street
Suite 302
San Francisco, CA 94118-1725

Mailing address

PO Box 320670
San Francisco, CA 94132
Phone (415) 658-7497

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
I20110228000782 CA Practitioner - GastroenterologyPractitioner - Internal Medicine 2961509278 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3580 California St
Suite 302
San Francisco, CA 94118-1715
Phone (415) 601-7999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G401240ILMDGastroenterology Physician

Hospital & facility affiliations 3

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1487759296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320670",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94132",
            "telephone_number": "415-658-7497",
            "fax_number": "415-929-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 CALIFORNIA STREET",
            "address_2": "SUITE 302",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181725",
            "telephone_number": "415-658-7497",
            "fax_number": "415-929-1307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "DEAN",
        "middle_name": "LOLLER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "G401240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.