Alexander Willoughby

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD196566 Issued in OR

Practice address

341 NW Medical Loop Ste 120
Roseburg, OR 97471-5546

Phone

(541) 440-6388

Fax

(541) 672-0665

NPI assigned

Jun 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Duke University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centennial Medical Group IncGroup PAC ID 6103982962, 60 clinicians

Umpqua Valley Eye Associates LLCGroup PAC ID 6608368204, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Roseburg, OR, CCN 380027

Merit-based Incentive Payment System (MIPS)

Final score

83.4 of 100Reported as group

Quality

67.01

Promoting interoperability

99

Improvement activities

40

Cost

78.48

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Centennial Medical Group Inc.

  • Surgery Physician
  • Roseburg, OR
  • NPI 1518103274
  Medicare reassignment Care Compare group NPD
• Umpqua Valley Eye Associates LLC

  • Ophthalmology Physician
  • Roseburg, OR
  • NPI 1609759174
  Medicare reassignment Care Compare group NPD
• Optical Shop Equipment Inc

  • Eyewear Supplier
  • Roseburg, OR
  • NPI 1871962951

  Ophthalmology

  NPD Authorized official
• Centennial Medical Group Inc.

  • Cardiovascular Disease Physician
  • Roseburg, OR
  • NPI 1033365135
  NPD

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

• Commonspirit Oregon

  • General Acute Care Hospital
  • Roseburg, OR
  • NPI 1477590198
  Care Compare affiliation

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1093166191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW MEDICAL LOOP STE 190",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718835",
            "telephone_number": "541-677-4319",
            "fax_number": "541-677-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 NW MEDICAL LOOP STE 120",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715546",
            "telephone_number": "541-440-6388",
            "fax_number": "541-672-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "ALEXANDER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "MD196566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD196566",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Nichole Williams
• Gary Christopher Willis
• Terry Lynn Willis
• William Lee Willis, DDS
• Shelli Willman, RDN, LD
• Austin Wilson
• Colleen Elizabeth Wilson, CTRS
• Daniel Stuart Wilson
• Jennifer Ann Brough Wilson, PA
• Joshua Wilson

• Ophthalmology Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Ophthalmology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.