Individual provider Active NPI

Reuben Makala Anders, MD

  • Dermatology Physician
  • Sonoma, CA
National Provider Identifier
1922029271
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A79025 Issued in CA
Practice address
461 7TH St W Ste 3
Sonoma, CA 95476-5976
Phone
(707) 938-1423
NPI assigned
Jul 22, 2006
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00046746 WA
Dermatology Physician 207N00000X MD-13554 HI
Dermatology Physician 207N00000X A79025 CA Primary

Addresses

Primary practice location

461 7TH St W Ste 3
Sonoma, CA 95476-5976

Mailing address

461 7TH St W Ste 3
Sonoma, CA 95476-5976
Phone (707) 938-1423

Other identifiers 4

IdentifierTypeStateIssuer
00A790250OtherCAMEDICARE PTAN
3298ANOtherWABLUE SHIELD #
7590826OtherWAAETNA#
8463564MedicaidWA

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
I20071213000497 CA Practitioner - Dermatology 6204854979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Loma Linda University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
R Makala Anders MD Medical CorporationGroup PAC ID 5890850200, 2 clinicians

Practice addresses (Care Compare)

461 7TH St W
Suite 3
Sonoma, CA 95476-5976
Phone (707) 938-1423

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as group
Quality
93.47
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision34
Removal of skin lesions1849
Removal of skin cancer179
Removal or shaving of skin growth1-10
Skin biopsy505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79025CAMDPharmacist
A79025CAMDDermatology Physician
MD00046746WAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R Makala Anders MD Medical Corporation Dermatology CurrentSince Dec 5, 2008 Accepting new patients
N. Charles Diakon D.O. a.P.C Past Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3020 Beard Rd
Napa, CA 94558
Phone (707) 252-1393

999 Adams St
Ste 201
Saint Helena, CA 94574
Phone (707) 963-5294

830 2nd St
#A
Santa Rosa, CA 95404
Phone (707) 380-1838

864 2nd St
#B
Santa Rosa, CA 95404
Phone (707) 542-5664

461 7th St W
Ste 3
Sonoma, CA 95476
Phone (707) 938-1423

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1922029271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 7TH ST W STE 3",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765976",
            "telephone_number": "707-938-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 7TH ST W STE 3",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765976",
            "telephone_number": "707-938-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "REUBEN",
        "middle_name": "MAKALA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00046746",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "HI",
            "license": "MD-13554",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A79025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00A790250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "3298AN",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA#",
            "identifier": "7590826",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8463564",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonoma, CA

Sources for this page

Verify at the official NPI Registry.