Individual provider Active NPI

Samuel Eric Willis, MD

  • Family Medicine Physician
  • Pasadena, TX
National Provider Identifier
1396892410
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M5584 Issued in TX
Practice address
927 Shaw Ave
Pasadena, TX 77506-1430
Phone
(713) 982-5900
NPI assigned
Jan 3, 2007
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M5584 TX Primary

Addresses

Primary practice location

927 Shaw Ave
Pasadena, TX 77506-1430

Mailing address

1 Baylor PLZ
Department of Family Medicine
Houston, TX 77030-3411

Other practice location 1

1 Baylor Plz
Department of Family Medicine
Houston, TX 77030-3411
Phone (713) 798-7700

Other identifiers 1

IdentifierTypeStateIssuer
P00457331OtherTXMEDICARE RAILROAD

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
I20080109000176 TX Practitioner - Family Practice 5698855203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians

Practice addresses (Care Compare)

1502 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-4900

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

1623 Airline Dr
Houston, TX 77009-3607
Phone (713) 798-1000

3550 Swingle Rd
Houston, TX 77047-3763
Phone (713) 547-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.87 of 100Reported as group
Quality
87.77
Improvement activities
40
Cost
76.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5584TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Family Medicine CurrentSince Jul 1, 2007 Accepting new patients
Abundantly Living Home Care LLC Current Accepting new patients
Baylor College of Medicine CurrentSince Jul 1, 2007 Accepting new patients
Abundantly Living Home Care LLC Current Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

927 Shaw Ave
Pasadena, TX 77506
Phone (713) 982-5168

Organizations & group practices 5

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 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1396892410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 SHAW AVE",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775061430",
            "telephone_number": "713-982-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Baylor Plz",
            "address_2": "Department of Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303411",
            "country_code": "US",
            "telephone_number": "713-798-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SAMUEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M5584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00457331",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.