Todd Mathew Anderson, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

19022431 Issued in IL

Practice address

1675 Bethany Rd
Suite a
Sycamore, IL 60178

Phone

(815) 895-3000

Fax

(815) 895-0505

NPI assigned

Sep 1, 2006

Last updated

Jul 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Maxillofacial Surgery

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oral and Maxillo Facial Surgeons for Northern IllinoisGroup PAC ID 2769416999, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Oral and Maxillo Facial Surgeons for Northern Illinois

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Sycamore, IL
  • NPI 1851583603

  Oral and Maxillofacial Surgery

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1497867626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE A",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-895-3000",
            "fax_number": "815-895-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BETHANY RD",
            "address_2": "SUITE A",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-895-3000",
            "fax_number": "815-895-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TODD",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021001563",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "19022431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley Anne Amptmann
• Hannah Jeanne Amundson, LSW
• Jackie Nicole Anderson
• Jessica R Anderson, FNP-BC
• Kathy Ann Anderson, MD
• Christina L Andre, DO
• Andrews Chiropractic, LTD. (Sycamore Chiropractic)
• David G Andrews, D.C.
• Melissa L Andrews, D.C.
• Amy Antczak

• Oral & Maxillofacial Surgery (D.M.D.) in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.