Individual provider Active NPI

Roger Willis, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1386683423
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L0702 Issued in TX
Practice address
8026 Floyd Curl
San Antonio, TX 78229-3915
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L0702 TX Primary

Addresses

Primary practice location

8026 Floyd Curl
San Antonio, TX 78229-3915

Mailing address

PO Box 2099
San Antonio, TX 78297-2099
Phone (210) 558-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080425000151 TX Practitioner - Emergency Medicine 0042398414 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.72 of 100Reported as group
Quality
91.03
Improvement activities
40
Cost
86.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L0702TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Emergency Group LLC Emergency Medicine CurrentSince Oct 15, 2021 Accepting new patients
Victoria Emergency Partners LLC Emergency Medicine CurrentSince May 1, 2017 Accepting new patients
Lone Star Emergency Associates LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jul 26, 2019 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jul 26, 2019 Accepting new patients
Gonzales Emergency Partners, PLLC Emergency Medicine CurrentSince Dec 1, 2023 Accepting new patients
Impact Medical Services, PA Emergency Medicine Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

110 Shult Dr
Columbus, TX 78934
Phone (979) 493-7560

2550 N Esplanade St
Cuero, TX 77954
Phone (361) 275-0532

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

1200 Carl Ramert Dr
Yoakum, TX 77995
Phone (361) 293-2321

Interoperability endpoints

  • Direct secure messaging: smmrwilli@yourcarecommunity.org

Organizations & group practices 7

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1386683423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2099",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782972099",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8026 FLOYD CURL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293915",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ROGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L0702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.