Tamara L Willis-Buckley, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

44373 Issued in CO

Practice address

1701 W 72ND Ave
Denver, CO 80221-2721

Phone

(303) 650-4460

NPI assigned

Jun 8, 2006

Sex

Female

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 3

Other names 1

• Tamara L Willis Former name

Medicare fee-for-service enrollment

Enrolled in CA, HI, CO3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Christian J. York, M.D., P.C.

  • Obstetrics & Gynecology Physician
  • Colorado Springs, CO
  • NPI 1053563155
  Medicare reassignment NPD
• Clinica Campesina Family Health Services

  • Clinic/Center
  • Lafayette, CO
  • NPI 1225025406
  Medicare reassignment NPD
• Obhg Colorado, P.C.

  • Obstetrics & Gynecology Physician
  • Colorado Springs, CO
  • NPI 1104116896
  Medicare reassignment NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1730166034
  Medicare reassignment NPD
• Kauai Medical Clinic

  • Multi-Specialty Clinic/Center
  • Lihue, HI
  • NPI 1376596643
  Medicare reassignment NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Queens North Hawaii Community Hospital

  • Orthopaedic Surgery Physician
  • Kamuela, HI
  • NPI 1528049814

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Regents of the University of California

  • Obstetrics & Gynecology Physician
  • Orange, CA
  • NPI 1356304034
  Medicare reassignment NPD
• Clinica Campesina Family Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longmont, CO
  • NPI 1558109223
  NPD
• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1871347443
  NPD
• Kauai Medical Clinic

  • Durable Medical Equipment & Medical Supplies
  • Koloa, HI
  • NPI 1871611558
  NPD
• Queens North Hawaii Community Hospital

  • General Acute Care Hospital
  • Kamuela, HI
  • NPI 1477559029
  NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1669413126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 PHEASANT RUN",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805138473",
            "telephone_number": "970-581-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W 72ND AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802212721",
            "telephone_number": "303-650-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS-BUCKLEY",
        "first_name": "TAMARA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "HI",
            "license": "MD-13841",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "44373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "018888",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA BILLING NUMBER",
            "identifier": "0000260901",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23825545",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "WILLIS",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie Williamson, MSW, SWC
• Alyssa Anne Willie, MSW
• Michael Willig, MD
• Melanie Willimann, MD
• Maren Losh Willins, MSW, LCSW
• Carson Bell Willis
• Danielle Geno Willis, LCSW
• Dyrell Decal Willis, LMT0022347
• Erik Willis
• Robert Willis Jr., PHARMD

• Obstetrics & Gynecology Physician in Denver, CO
• Providers in Denver, CO by specialty
• Obstetrics & Gynecology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.