Individual provider Active NPI

Michael E. Willers, MD

  • Pediatric Cardiology Physician
  • Holyoke, MA
National Provider Identifier
1518087790
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
237999 Issued in MA
Practice address
1754 Northampton Street
Holyoke, MA 01040
Phone
(413) 315-3117
Fax
(866) 229-2767
NPI assigned
Mar 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 237999 MA
Pediatric Cardiology Physician 2080P0202X 237999 MA Primary

Addresses

Primary practice location

1754 Northampton Street
Holyoke, MA 01040

Mailing address

1754 Northampton Street
Holyoke, MA 01040
Phone (413) 315-3117

Other identifiers 2

IdentifierTypeStateIssuer
008030403MedicaidCT
110080495AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081021000869 MA Practitioner - Cardiovascular Disease (Cardiology) 6608934591 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Geisel School of Medicine at Dartmouth, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237999MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc Pediatrics CurrentSince Apr 15, 2023 Accepting new patients
The General Hospital Corporation CurrentSince Mar 1, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Mar 1, 2022 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

50 Wason Ave
Springfield, MA 01107
Phone (413) 794-2515

Organizations & group practices 3

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1518087790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 NORTHAMPTON STREET",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "01040",
            "telephone_number": "413-315-3117",
            "fax_number": "866-229-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 NORTHAMPTON STREET",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "01040",
            "telephone_number": "413-315-3117",
            "fax_number": "866-229-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLERS",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "237999",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": "237999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008030403",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110080495A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.