TODD MATHEW ANDERSON, DDS — NPI 1497867626 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery in SYCAMORE, IL)

CMS-1500 Box 24J / 33a • NPI

1497867626

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

204E00000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery

Box 32 Service Location & ZIP+4

1675 BETHANY RD, SUITE A, SYCAMORE, IL, 60178

Official NPPES Practice Location

Practice Phone & Referral Fax

(815) 895-3000

Fax: (815) 895-0505

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1497867626 (TODD MATHEW ANDERSON, DDS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1497867626` (NPI-1 Individual Practitioner)
Provider / Legal Name	TODD MATHEW ANDERSON, DDS
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery NUCC Code: `204E00000X` (Oral & Maxillofacial Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1675 BETHANY RD, SUITE A, SYCAMORE, IL, 60178
Practice Telephone / Fax	Tel: (815) 895-3000 \| Fax: (815) 895-0505
Administrative Mailing Address	1675 BETHANY RD, SYCAMORE, IL, 60178
Enumeration & Last Sync	Enumerated: 2006-09-01 \| CMS Record Updated: 2019-07-19

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1675 BETHANY RD, SUITE A, SYCAMORE, IL, 60178

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Plain-English Taxonomy & CMS Crosswalk (204E00000X)

What Does Taxonomy Code 204E00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 204E00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 85 (Physician/Maxillofacial Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Oral & Maxillofacial Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TODD MATHEW ANDERSON, DDS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1223S0112X` — Dentist, Oral and Maxillofacial Surgery Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: IL \| License: `021001563` \| Primary: Secondary
`204E00000X` — Oral & Maxillofacial Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Oral & Maxillofacial Surgery	State: IL \| License: `19022431` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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TODD MATHEW ANDERSON, DDS (NPI #1497867626)