Brian Willie

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601007254 Issued in MI

Practice address

370 N 120TH Ave
Holland, MI 49424-2196

Phone

(616) 396-5855

Fax

(616) 396-5720

NPI assigned

Dec 30, 2014

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopaedic Associates of Muskegon PCGroup PAC ID 7214908045, 113 clinicians

Shoreline Orthopaedic and Sports Medicine Clinic P L CGroup PAC ID 6002891926, 25 clinicians

Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians

Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holland Hospital Hospital, Holland, MI, CCN 230072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Orthopaedic Associates of Muskegon, PC

  • Orthopaedic Surgery Physician
  • Muskegon, MI
  • NPI 1972566594
  Medicare reassignment Care Compare group NPD
• Shoreline Orthopaedic & Sports Medicine Clinic,PLC

  • Orthopaedic Surgery Physician
  • Holland, MI
  • NPI 1275579765
  Medicare reassignment Care Compare group
• Center for Physical Rehabilitation and Therapy LP

  • Physical Therapy Clinic/Center
  • Grand Rapids, MI
  • NPI 1902288863
  Care Compare group
• Orthopaedic Associates of Muskegon, PC

  • Orthopaedic Surgery Physician
  • Grand Haven, MI
  • NPI 1215650221
  NPD
• Shoreline Orthopaedic & Sports Medicine Clinic P L C

  • Durable Medical Equipment & Medical Supplies
  • Zeeland, MI
  • NPI 1881370799
  NPD

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

• Holland Community Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  Care Compare affiliation

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1154719144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIE",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601007254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danae Joy Willenberg Langholz, D.M.D., M.S.
• Anakah Williams
• Mackenzee Williams
• Samuel M Williams, LPN
• Stephanie Williams
• Bradley L Willoughby, MD
• Kara Anne Willoughby, MD
• Beth Wilmot, LMSW
• Amy Wilson
• Carolynn E Wilson, RN

• Surgical Physician Assistant in Holland, MI
• Providers in Holland, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.