Austin Joe Willis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1310 Club Dr
Vallejo, CA 94592-1187

Phone

(707) 638-5809

NPI assigned

May 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Touro Un College of Osteopathic Medicine, Vallejo, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Merit-based Incentive Payment System (MIPS)

Final score

87.97 of 100Reported as group

Quality

47.69

Promoting interoperability

100

Improvement activities

40

Cost

82.27

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Torrance Health Association Inc

  dba Torrance Memorial Physician Network

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1083903124
  Medicare reassignment Care Compare group NPD
• Kern County Hospital Authority

  dba Kern Medical Center

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1376623538
  Medicare reassignment NPD
• Kern County Hospital Authority

  • Federally Qualified Health Center (FQHC)
  • Bakersfield, CA
  • NPI 1164974739
  NPD

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

• Torrance Memorial Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1467459776
  Care Compare affiliation

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

{
    "created_epoch": "1621123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621123200000",
    "number": "1023682986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3476 S LELAND ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907316126",
            "telephone_number": "310-922-4637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 CLUB DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945921187",
            "telephone_number": "707-638-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AUSTIN",
        "middle_name": "JOE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-16",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omari Williams
• Ronald Bernard Williams, D.C.
• Andrew Moore Williamson, M.A.
• Scott Williamson, C.R.N.A.
• Jason Willis-Shore, MD
• Kyle Willson, DPM
• Shameeka Monay Wilson-Brown
• Amber Wilson-Tyler
• Deanna K. Wilson, MD
• Dewight Edwin Wilson, RADT1

• Physician Assistant in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2021; 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.