Individual provider Active NPI

Martha Pauline Wills, M.D., F.A.C.S., P.A.

  • Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1154416600
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
J0367 Issued in TX
Practice address
10840 Texas Health TRL Ste 200
Fort Worth, TX 76244-6848
Phone
(817) 595-8822
Fax
(817) 595-8833
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X J0367 TX Primary

Addresses

Primary practice location

10840 Texas Health TRL Ste 200
Fort Worth, TX 76244-6848

Mailing address

10840 Texas Health TRL Ste 200
Fort Worth, TX 76244-6848
Phone (817) 595-8822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20110609000165 TX Practitioner - General Surgery 9537185178

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical School at San Antonio, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3848 N Tarrant Pkwy
Suite 110
Fort Worth, TX 76244-5421

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
J0367TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha P. Wills, M.D., F.a.C.S., PA Surgery CurrentSince Jul 1, 2003 Accepting new patients
Utmb Faculty Group Practice Surgery Past Accepting new patients
Texas Gulf Coast Medical System, Inc Past Accepting new patients

Locations

3848 North Tarrant Pkwy
Ste 110
Fort Worth, TX 76244
Phone (817) 595-8822

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 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1154416600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10840 TEXAS HEALTH TRL STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446848",
            "telephone_number": "817-595-8822",
            "fax_number": "817-595-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10840 TEXAS HEALTH TRL STE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446848",
            "telephone_number": "817-595-8822",
            "fax_number": "817-595-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "MARTHA",
        "middle_name": "PAULINE",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S., P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J0367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.