Individual provider Active NPI

William J Walsh, PA

  • Physician Assistant
  • Naples, FL
National Provider Identifier
1669407029
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA0003120 Issued in FL
Practice address
6376 Pine Ridge Rd Unit 180
Naples, FL 34119-3926
Phone
(239) 263-0849
Fax
(239) 263-2376
NPI assigned
Jul 12, 2006
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA0003120 FL Primary

Addresses

Primary practice location

6376 Pine Ridge Rd Unit 180
Naples, FL 34119-3926

Mailing address

6376 Pine Ridge Rd # Unite180
Naples, FL 34119-3908
Phone (239) 263-0849

Other practice location 1

730 Goodlette Rd Ste 100
Naples, FL 34102-5617
Phone (239) 682-6603

Other identifiers 3

IdentifierTypeStateIssuer
000414700MedicaidFL
Y04N9OtherBCBS
40916LOtherFLBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20041109000960 FL Practitioner - Physician Assistant 2860455912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Naples Heart Rhythm Specialists PAGroup PAC ID 8729177035, 21 clinicians

Practice addresses (Care Compare)

6376 Pine Ridge Rd
Naples, FL 34119-3926
Phone (239) 263-0849

730 Goodlette Rd N
Suite 100
Naples, FL 34102-5617
Phone (239) 682-6603

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.38 of 100Reported as group
Quality
72.26
Promoting interoperability
100
Improvement activities
40
Cost
75.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA0003120FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anchor Health Centers PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.walsh.1@25641.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1669407029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6376 PINE RIDGE RD # UNITE180",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193908",
            "telephone_number": "239-263-0849",
            "fax_number": "239-263-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6376 PINE RIDGE RD UNIT 180",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193926",
            "telephone_number": "239-263-0849",
            "fax_number": "239-263-2376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 Goodlette Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025617",
            "country_code": "US",
            "telephone_number": "239-682-6603",
            "fax_number": "239-263-2014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA0003120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000414700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y04N9",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "40916L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.