Individual provider Active NPI

William Michael Dizon, PA-C

  • Physician Assistant
  • Mountain View, CA
National Provider Identifier
1730461054
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21791 Issued in CA
Practice address
701 El Camino Real
Mountain View, CA 94040-2833
Phone
(650) 934-7000
Fax
(831) 475-4344
NPI assigned
Sep 13, 2011
Last updated
Feb 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21791 CA Primary

Addresses

Primary practice location

701 El Camino Real
Mountain View, CA 94040-2833

Mailing address

2350 W. El Camino Real
2ND Floor
Mountain View, CA 94040-6203

Other identifiers 1

IdentifierTypeStateIssuer
PA21791OtherCASTATE OF CALIFORNIA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111115000232 CA Practitioner - Physician Assistant 6103090899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, shared by 16 NPIs, 3,783 clinicians

Practice addresses (Care Compare)

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

401 Old San Francisco Rd
Sunnyvale, CA 94086-6387
Phone (408) 739-6000

701 E El Camino Real
Mountain View, CA 94040-2833
Phone (650) 691-6174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA21791CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Sep 23, 2013 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
Sutter Bay Medical Foundation CurrentSince Mar 23, 2024 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Sep 23, 2013 Accepting new patients
Orthonorcal, Inc. Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Mountain View, CA 94040
Phone (408) 523-3103

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

2506 Samaritan Ct
San Jose, CA 95124
Phone (408) 523-3870

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: wdizon188339@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1730461054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W. EL CAMINO REAL",
            "address_2": "2ND FLOOR",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 EL CAMINO REAL",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940402833",
            "telephone_number": "650-934-7000",
            "fax_number": "831-475-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "PA21791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.