Individual provider Active NPI

Aaron Robin Willis, D.O

  • Pediatric Pulmonology Physician
  • Hollywood, FL
National Provider Identifier
1285096727
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
16208 Issued in FL
Practice address
1131 N 35TH Ave Ste 330
Hollywood, FL 33021-5403
Phone
(954) 265-6333
Fax
(954) 276-0756
NPI assigned
Mar 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 16208 FL Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 330
Hollywood, FL 33021-5403

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5603

Other practice location 1

1971 SW 172nd Ave Fl 2
Miramar, FL 33029-5592
Phone (954) 265-6333

Other identifiers 1

IdentifierTypeStateIssuer
119673700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awillis348621@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231114000318 FL Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 1850748864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Pediatric Medicine
Education
Nova Southeastern College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1131 N 35TH Ave
Hollywood, FL 33021-5403

4651 Sheridan St
Suite 150
Hollywood, FL 33021-3443
Phone (954) 265-6331

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16208FLMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Sep 11, 2023 Accepting new patients
South Broward Hospital District CurrentSince Sep 11, 2023 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

1131 N 35th Ave
Hollywood, FL 33021
Phone (954) 260-7919

1131 N 35th Ave
Ste 330
Hollywood, FL 33021
Phone (954) 265-4475

1971 SW 172nd Ave
Fl 2
Miramar, FL 33029
Phone (954) 265-6333

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

1971 SW 172nd Ave
Ste 2500
Miramar, FL 33029
Phone (954) 265-6333

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

Interoperability endpoints

  • Direct secure messaging: awillis348621@mhsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1285096727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 330",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-6333",
            "fax_number": "954-276-0756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1971 SW 172nd Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295592",
            "country_code": "US",
            "telephone_number": "954-265-6333",
            "fax_number": "954-276-0756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "AARON",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "16208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119673700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awillis348621@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1131 N 35th Ave Ste 330",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.