Michael L Willis, ADULT NURSE PRACTITI

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

302775 Issued in NY

Practice address

3201 Kings Highway
Beth Israel Medical Center
Brooklyn, NY 11234-2625

Phone

(718) 677-6669

NPI assigned

May 11, 2009

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

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.

• Bimc Faculty Practice

  • Neurology Physician
  • New York, NY
  • NPI 1891848461
  NPD (past)

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1235363847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 KINGS HIGHWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342625",
            "telephone_number": "718-677-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 KINGS HIGHWAY",
            "address_2": "BETH ISRAEL MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342625",
            "telephone_number": "718-677-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "ADULT NURSE PRACTITI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "302775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Jordan Willis
• James Martin Willis, MD
• Jessica Willis
• Keisha Willis
• Lushana Willis, RPH.
• Samantha Willis
• Velta Willis, NP
• Marc Willner, PHARM.D.
• Rochel Willner
• Marcelle Janice Willock

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.