Individual provider Active NPI

Jeffrey Willems, PHD

  • Psychologist
  • Stevens Point, WI
National Provider Identifier
1073886743
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3003-57 Issued in WI
Practice address
3398 E Maria Dr
Stevens Point, WI 54481-1362
Phone
(715) 341-7441
NPI assigned
Feb 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3003-57 WI Primary

Addresses

Primary practice location

3398 E Maria Dr
Stevens Point, WI 54481-1362

Mailing address

3398 E Maria Dr
Stevens Point, WI 54481-1362
Phone (715) 341-7441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130227000051 WI Practitioner - Clinical Psychologist 1254586183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Stevens Point Hospital and Clinics, Inc.Group PAC ID 1850358938, 136 clinicians

Practice addresses (Care Compare)

3398 E Maria Dr
Stevens Point, WI 54481-1362
Phone (715) 341-7441

Hospital & facility affiliations

  • Aspirus Stevens Point Hospital & Clinics, Inc. Hospital, Stevens Point, WI, CCN 520002

Merit-based Incentive Payment System (MIPS)

Final score
87.15 of 100Reported as group
Quality
73.7
Promoting interoperability
100
Improvement activities
40
Cost
76.71

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Aug 1, 2013 Accepting new patients
Mercy Medical Center of Oshkosh, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

3398 E Maria Dr
Stevens Point, WI 54481
Phone (715) 341-7441

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375660800000",
    "number": "1073886743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3398 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811362",
            "telephone_number": "715-341-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3398 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811362",
            "telephone_number": "715-341-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEMS",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2013-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3003-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.