Individual provider Active NPI

Lawrence Browning Willes, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • San Diego, CA
National Provider Identifier
1255633442
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A103827 Issued in CA
Practice address
200 W Arbor Dr # Mc8720
San Diego, CA 92103-9001
Phone
(619) 543-5966
NPI assigned
Nov 22, 2010
Last updated
Nov 22, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A103827 CA Primary

Addresses

Primary practice location

200 W Arbor Dr # Mc8720
San Diego, CA 92103-9001

Mailing address

200 W Arbor Dr # Mc8720
San Diego, CA 92103-9001
Phone (619) 543-5966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110728000211 CA Practitioner - Pathology 5193993673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glendale Pathology Associates Medical Group of GlendaleGroup PAC ID 2860482221, 8 clinicians

Practice addresses (Care Compare)

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8320

1509 Wilson Terrace
Glendale, CA 91206-4007

1720 Cesar E Chaves Ave
Los Angeles, CA 90033-2414
Phone (323) 268-5000

20350 Ventura Blvd
Suite 205
Woodland Hills, CA 91364-2488
Phone (818) 718-9510

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.98
Improvement activities
40
Cost
82.67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
103827CAMDClinical Social Worker
A103827CAMDAnatomic Pathology & Clinical Pathology Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1255633442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # MC8720",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR # MC8720",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039001",
            "telephone_number": "619-543-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLES",
        "first_name": "LAWRENCE",
        "middle_name": "BROWNING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A103827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.