Jeffrey Franklin Willard, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

10616 Issued in AZ

Practice address

1001 Willow Creek Rd Ste 3200
Prescott, AZ 86301-1614

Phone

(602) 406-4786

Fax

(916) 636-4358

NPI assigned

Sep 8, 2018

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, AZ2 enrollments

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 2

Specialty

Physician Assistant

Education

Indiana University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yavapai Regional Medical Center Physician Care LLCGroup PAC ID 5294898987, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwillard1@direct.iuhealth.org
• Direct secure messaging: jeffrey.willard@lutheranhealthnetwork.cernerdirect.com

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.

• Yavapai Regional Medical Center Physician Care LLC

  dba Yavapai Regional Medical Center Physician Care

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1255582003
  Medicare reassignment Care Compare group
• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983

  Physician Assistant

  Medicare reassignment NPD
• Yavapai Regional Medical Center Physician Care LLC

  dba Yavapai Regional Medical Center Physician Care

  • Internal Medicine Physician
  • Prescott, AZ
  • NPI 1083940399
  NPD
• Yavapai Regional Medical Center Physician Care LLC

  dba Yavapai Regional Medical Center Physician Care

  • Cardiovascular Disease Physician
  • Prescott, AZ
  • NPI 1528394830
  NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD
• Prescott Gastroenterology

  • Gastroenterology Physician
  • Prescott, AZ
  • NPI 1720110984
  NPD (past)

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

• Yavapai Community Hospital Association

  dba Yavapai Regional Medical Center

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1536364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1245713031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WILLOW CREEK RD STE 3200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011614",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JEFFREY",
        "middle_name": "FRANKLIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-08",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "10616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167155",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.willard@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7910 W Jefferson Blvd Ste 102",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hanna Magdalena Wiesner, LMT
• Amanda J Wikan, RD, LD
• Joan L Wilburg-Bourne
• Quinton Wiggins Wilder, LMT
• Sondra Wilkening, MS, LPC
• Sheila Michelle Willems, O.D.
• Willer Optometry, Inc (Patrick Willer)
• Patrick Allen Willer, OD
• William E. Perry, MD, PC
• Williams Eyecare Group LLC

• Surgical Physician Assistant in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.