NPIMap

Individual provider Active NPI

Ronald Joseph Willy, M.D.

  • Diagnostic Radiology Physician
  • Oceanside, CA
National Provider Identifier
1306802764
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01053083A Issued in IN
Practice address
200 Mercy Circle
Oceanside, CA 92055
Phone
(765) 210-9556
NPI assigned
Apr 25, 2006
Last updated
Feb 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01053083A IN Primary

Addresses

Primary practice location

200 Mercy Circle
Oceanside, CA 92055

Mailing address

200 Mercy Circle
Oceanside, CA 92055
Phone (765) 210-9556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240311003484 TX Practitioner - Diagnostic Radiology 4789091018 Reassigns benefits to 1 organization
I20240925001856 CA Practitioner - Diagnostic Radiology 4789091018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Warren Alpert Medical School of Brown University, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-5431

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01053083AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Radiology Medical Group Inc. Diagnostic Radiology CurrentSince Aug 26, 2024 Accepting new patients
Humboldt Radiology Medical Group Inc Diagnostic Radiology Current Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Feb 4, 2024 Accepting new patients
Tuba City Regional Health Care Corporation Current Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Feb 4, 2024 Accepting new patients
Humboldt Radiology Medical Group Inc Diagnostic Radiology CurrentSince Aug 26, 2024 Accepting new patients

Locations

2330 Buhne St
Eureka, CA 95501
Phone (707) 442-3704

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

3300 Renner Dr
Fortuna, CA 95540
Phone (707) 725-3361

Organizations & group practices 6

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 6

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1306802764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "765-210-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "765-210-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLY",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2023-02-07",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01053083A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

Verify at the official NPI Registry.