William Angkadjaja, MD

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

A156962 Issued in CA

Practice address

1910 Orange Tree LN Ste 320
Redlands, CA 92374-4500

Phone

(909) 793-2363

NPI assigned

Apr 18, 2017

Last updated

Jul 13, 2020By 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 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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Redlands Community Hospital Home Health Care Services Home health agency, Redlands, CA, CCN 057494
• Redlands Community Hospital Hospital, Redlands, CA, CCN 050272

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Inland Primary Care, Inc

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1881202661
  Medicare reassignment NPD
• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Redlands Community Hospital

  • General Acute Care Hospital
  • Redlands, CA
  • NPI 1043354111
  Care Compare affiliation
• Redlands Community Hospital

  • Home Health Agency
  • Redlands, CA
  • NPI 1407990575
  Care Compare affiliation

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1871027722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 ORANGE TREE LN STE 320",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ORANGE TREE LN STE 320",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744500",
            "telephone_number": "909-793-2363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "LLUH Family Medicine Residency",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGKADJAJA",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A156962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Care Transport LLC
• Angel Hands Therapy Services Inc.
• Christopher Peter Angel
• Gregory Angeloni, LVN
• Julia Yutin Angkadjaja, M.D.
• Anil P Punjabi, MD, DDS, Inc.
• Jordan Ankenman, LMFT
• Nicole Michelle Antonio, M.D.
• Martha Anzola
• Lorenzo A Apodaca, M.D.

• Adult Medicine Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.