NPIMap

Individual provider Active NPI

Jonathan Willis, M.D.

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1437538162
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R0157 Issued in TX
Practice address
851 N Loop 340
Waco, TX 76705-2592
Phone
(254) 202-7500
Fax
(254) 202-7599
NPI assigned
May 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10053880 TX
Family Medicine Physician 207Q00000X R0157 TX Primary

Addresses

Primary practice location

851 N Loop 340
Waco, TX 76705-2592

Mailing address

PO Box 848476
Dallas, TX 75284-8476
Phone (254) 202-4655

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwillis335258@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180718002774 TX Practitioner - Family Practice 0547564452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Family Health CenterGroup PAC ID 4183612278, 62 clinicians

Practice addresses (Care Compare)

851 N Loop
340 B S and W H Clinic Bellmead
Waco, TX 76705-2592
Phone (254) 202-7500

Hospital & facility affiliations

  • Accentcare Home Health of Waco Home health agency, Waco, TX, CCN 679200
  • Centerwell Home Health Home health agency, Waco, TX, CCN 457095
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
  • Ascension Providence Hospital, Waco, TX, CCN 450042
  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Family Health Center Family Medicine CurrentSince Jul 1, 2018 Accepting new patients
Soheil Hekmat, MD, Inc. Past Accepting new patients

Locations

851 N Loop 340
#B
Waco, TX 76705
Phone (254) 202-7500

851 N Loop 340
Waco, TX 76705
Phone (254) 202-7500

Interoperability endpoints

  • Direct secure messaging: jwillis335258@direct.sw.org

Organizations & group practices 2

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.

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1437538162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848476",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848476",
            "telephone_number": "254-202-4655",
            "fax_number": "254-202-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 N LOOP 340",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767052592",
            "telephone_number": "254-202-7500",
            "fax_number": "254-202-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10053880",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R0157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwillis335258@direct.sw.org",
            "affiliation": "N",
            "address_1": "851 N Loop 340",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767052592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.