Paul Dana Willms, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F344523 Issued in NY

Practice address

635 Belle Terre Rd
Port Jefferson, NY 11777-1935

Phone

(631) 320-7503

NPI assigned

Feb 25, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

True North Medical Group PCGroup PAC ID 7012194806, 185 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations (25 of 27)

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.

• True North Medical Group PC

  • Orthopaedic Surgery Physician
  • Merrick, NY
  • NPI 1659883486
  Medicare reassignment Care Compare group NPD
• Ashraf Medical Group PLLC

  • Urgent Care Clinic/Center
  • Wappingers Falls, NY
  • NPI 1821387382
  Medicare reassignment NPD
• True North Medical Group PC

  • Oxygen Equipment & Supplies (DME)
  • Tarrytown, NY
  • NPI 1669272886
  NPD
• True North Medical Group PC

  • Cardiovascular Disease Physician
  • Bayside, NY
  • NPI 1669762258
  NPD (past)
• Westchester Health Associates, P.L.L.C

  • Internal Medicine Physician
  • Katonah, NY
  • NPI 1508088907
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1629602081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "968595001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BELLE TERRE RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771935",
            "telephone_number": "631-320-7503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1862 Pleasantville Rd",
            "address_purpose": "LOCATION",
            "city": "Briarcliff Manor",
            "state": "NY",
            "postal_code": "105101025",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "696 Dutchess Tpke",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126036444",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 Route 6 Ste 1N",
            "address_purpose": "LOCATION",
            "city": "Mahopac",
            "state": "NY",
            "postal_code": "105411716",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Route 376 Ste H",
            "address_purpose": "LOCATION",
            "city": "Wappingers Falls",
            "state": "NY",
            "postal_code": "125906496",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 Marble Ave",
            "address_purpose": "LOCATION",
            "city": "Thornwood",
            "state": "NY",
            "postal_code": "105941062",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26 Winslow Gate Rd Bldg C2",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126011467",
            "country_code": "US",
            "telephone_number": "845-204-9260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLMS",
        "first_name": "PAUL",
        "middle_name": "DANA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-25",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NY",
            "license": "F344523",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "F344523",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F344523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole White
• Ian Ralph Whiteside, M.D.
• Barbara J Wickenhauser
• Michelle K Wiley
• Robert G Williams, DDS
• Lisa Nicole Wilson, NP
• Robert Steven Wilutis, MS OTR CHT
• Deborah A Winslow, N.P.
• Florence Mary Wissert, NPP,FNP,CARN,CS
• John Joseph Woehrle, RPA-C

• Family Nurse Practitioner in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.