Individual provider Active NPI

William R Coleman, MD

  • Dermatology Physician
  • Northridge, CA
National Provider Identifier
1760404792
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G67719 Issued in CA
Practice address
9535 Reseda Boulevard
Suite 304
Northridge, CA 91324-6029
Phone
(818) 886-3884
Fax
(818) 886-5418
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G67719 CA Primary

Addresses

Primary practice location

9535 Reseda Boulevard
Suite 304
Northridge, CA 91324-6029

Mailing address

9535 Reseda Boulevard
Suite 304
Northridge, CA 91324-6029
Phone (818) 886-3884

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
I20101008000494 CA Practitioner - Dermatology 6406913078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Un of California, Irvine, College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin and Beauty Center IncGroup PAC ID 8628170347, 34 clinicians

Practice addresses (Care Compare)

9535 Reseda Blvd
Suite 304
Northridge, CA 91324-6029
Phone (818) 886-3884

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Promoting interoperability
88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1023
Removal of skin cancer1-10
Removal or shaving of skin growth1-10
Skin biopsy276

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67719CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin and Beauty Center (SBC), Inc. - Glendale Dermatology CurrentSince Apr 1, 2014 Accepting new patients
Skin and Beauty Center Inc Dermatology CurrentSince Apr 1, 2014 Accepting new patients
Cardiology Associates Medical Group Past Accepting new patients
Skin and Beauty Center (SBC), Inc. Dermatology Past Accepting new patients

Locations

8950 W Olympic Blvd
Ste 171
Beverly Hills, CA 90211

2720 W Magnolia Blvd
Burbank, CA 91505
Phone (818) 842-8000

191 S Buena Vista St
Ste 475
Burbank, CA 91505
Phone (818) 322-0126

9535 Reseda Blvd
Ste 304
Northridge, CA 91324
Phone (818) 886-3884

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: wcoleman@dcm-ca.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760404792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9535 RESEDA BOULEVARD",
            "address_2": "SUITE 304",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913246029",
            "telephone_number": "818-886-3884",
            "fax_number": "818-886-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9535 RESEDA BOULEVARD",
            "address_2": "SUITE 304",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913246029",
            "telephone_number": "818-886-3884",
            "fax_number": "818-886-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G67719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.