Elliott Herschel Willis, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS003457L Issued in PA

Practice address

301 Oxford Valley Rd
Suite 905a
Yardley, PA 19067-7706

Phone

(215) 321-9896

Fax

(215) 321-4369

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Aria Health Physician Services

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384646400000",
    "number": "1649218975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "SUITE 905A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190677706",
            "telephone_number": "215-321-9896",
            "fax_number": "215-321-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "SUITE 905A",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190677706",
            "telephone_number": "215-321-9896",
            "fax_number": "215-321-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ELLIOTT",
        "middle_name": "HERSCHEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS003457L",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB03196100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE IBC",
            "identifier": "0022645000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "35651OS003457L",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0070048520002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "6296514",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "105263",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MED",
            "identifier": "080084616",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30079314",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann White, PT, DPT, COMT
• Michael David Widlitz, M.D.
• Lorraine Wiegand
• Michele Caroline Willems Plakyda, MD
• Aundrea Williams, PHARMD
• Lance B Wilson, MD
• Michelle Wilson
• Phillip Wind, PHARMD
• Guinivere Lynn Winokur, CRNP, NP-C
• Nicholas C. Winter, PH.D.

• Family Medicine Physician in Yardley, PA
• Providers in Yardley, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.