Individual provider Active NPI

Yael Kreitman Willingham, M.D.

  • Otolaryngology Physician
  • Killeen, TX
National Provider Identifier
1609133099
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
R3124 Issued in TX
Practice address
2405 S Clear Creek Rd
Killeen, TX 76549
Phone
(254) 618-1888
NPI assigned
Apr 23, 2012
Last updated
Jan 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R3124 TX Primary
Otolaryngology Physician 207Y00000X BP10043148 TX

Addresses

Primary practice location

2405 S Clear Creek Rd
Killeen, TX 76549

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-8800

Other practice location 1

2405 S Clear Creek Rd
Killeen, TX 76549
Phone (254) 618-1888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ykreitman14590@direct.sw.org

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
I20170824000916 TX Practitioner - Otolaryngology 2062795578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4887 Williams Dr
BLDG 2 Suite 203
Georgetown, TX 78633-2441
Phone (512) 425-0852

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10043148TXMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family ENT of Georgetown PLLC Otolaryngology CurrentSince Sep 26, 2024 Accepting new patients

Locations

4887 Williams Dr
Ste 203
Georgetown, TX 78633
Phone (512) 425-0852

Organizations & group practices 1

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 4

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1609133099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 S CLEAR CREEK RD",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76549",
            "telephone_number": "254-618-1888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2405 S Clear Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "76549",
            "country_code": "US",
            "telephone_number": "254-618-1888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "YAEL",
        "middle_name": "KREITMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "R3124",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "BP10043148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ykreitman14590@direct.sw.org",
            "affiliation": "N",
            "address_1": "2405 S Clear Creek Rd",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "76549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.