WILLIAM VANDERWALL P.A.-C
NPI 1205123783
Physician Assistant - Surgical in Brooklyn, NY

Active since July 05, 2011PECOS EnrolledAccepts Medicare Assignment
121 DEKALB AVE, BROOKLYN, NY 11201(718) 250-8000 Get Directions Write a Review

NPPES record last updated: July 5, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About William Vanderwall P.a.-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIAM VANDERWALL P.A.-C (NPI 1205123783) is an individual surgical provider in Brooklyn, New York, licensed in New York (014744) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with Brooklyn Hospital Center - Downtown Campus, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1205123783
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameWILLIAM VANDERWALLCredential: P.A.-C
Location Address121 DEKALB AVEBrooklyn, NY 11201-5425
Mailing Address1288 1st Ave Apt 5fsNew York, NY 10021-5568
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 5, 2011
NPI 1205123783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in NY · 014744
121 DEKALB AVE, Brooklyn, NY 11201

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

William Vanderwall P.a.-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42466518
PECOS Enrollment IDI20120816000202
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Brooklyn Hospital Center - Downtown Campus

Acute Care Hospitals · Brooklyn, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number330056
Location121 Dekalb AvenueBrooklyn, NY 11201 · Kings County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist (Nutrition Support)
121 DEKALB AVE, B231
BROOKLYN, NY 11201
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201
Orthopaedic Surgery (Hand Surgery)
121 DEKALB AVE, ORTHOSUITE
BROOKLYN, NY 11201
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE, HOUSE STAFF ADMINISTRATION
BROOKLYN, NY 11201
Physical Therapist
121 DEKALB AVE
BROOKLYN, NY 11201
Nurse Practitioner (Family)
121 DEKALB AVE
BROOKLYN, NY 11201
Student in an Organized Health Care Education/Training Program
121 DEKALB AVE
BROOKLYN, NY 11201

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is William Vanderwall's NPI number?

The NPI number for William Vanderwall is 1205123783. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Where is William Vanderwall located?

William Vanderwall practices at 121 Dekalb Ave, Brooklyn, NY 11201. The listed phone number is (718) 250-8000.

What is William Vanderwall's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is William Vanderwall enrolled in Medicare?

Yes. William Vanderwall is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is William Vanderwall affiliated with any hospitals?

According to CMS data, William Vanderwall is affiliated with Brooklyn Hospital Center - Downtown Campus.

When was this NPI record last updated?

The NPPES record for William Vanderwall was last updated on July 5, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.