Zachary Randall Willis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

025386 Issued in NY

Practice address

50 Leroy St
Potsdam, NY 13676-1799

Phone

(315) 265-3300

NPI assigned

Jul 28, 2020

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 NY, MD2 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

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

81.6 of 100Reported as group

Quality

76.36

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: zwillis1144016@direct.umm.edu

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.

• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  MD

  Medicare reassignment NPD
• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Medicare reassignment
• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Medicare reassignment
• Canton-Potsdam Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potsdam, NY
  • NPI 1114104445
  NPD
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1265041073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 CR 35",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136763143",
            "telephone_number": "443-417-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761799",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ZACHARY",
        "middle_name": "RANDALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael B Whitehead, P.A.
• Michelle Whitton
• Roberta L Wiggins, R.N.
• William J. Detorres, III, MD PC
• Richard W. Williams, RICHARD WILLIAMS PHD
• Maren Michelle Wolfe, PH.D.
• Womens Room OBGYN PLLC
• Emily Louise Wood, M.D.
• Alisa Genevieve Woods, PHD, LMHC
• Susanne Yenoli, PT

• Physician Assistant in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.