Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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William Vanderwall, PA-C

Individual provider Surgical Physician Assistant · NPI 1205123783

William Vanderwall, PA-C is a Physician Assistant in Brooklyn, New York. Qualified in 2010, 16 years ago. Practices with Tbhc Physician Services PC, a 113-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone: (718) 250-8000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 014744 (NY)

Record details

NPI number1205123783
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 5, 2011
Last updated in NPPESJuly 5, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Tbhc Physician Services Pc — 113 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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