Matthew Clifford Willett, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

132174 Issued in CA

Practice address

Naval Hospital Camp Pendleton
200 Mercy Circle
Camp Pendleton, CA 92055-5191

Phone

(760) 719-3249

NPI assigned

Feb 22, 2013

Last updated

Feb 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NM, PA3 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

Specialty

Dermatology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Pacific Dermatology InstituteGroup PAC ID 2062546260, 32 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 29)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17606/brand/1/csg/1/fhir/r4
• Direct secure messaging: mwillett346213@direct-sluhn.org

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.

• Pacific Dermatology Institute

  • Dermatology Physician
  • Corona, CA
  • NPI 1740410182
  Medicare reassignment Care Compare group NPD
• Scripps Health

  dba Scripps Clinic

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  Dermatology

  Medicare reassignment Care Compare group NPD
• Advanced Dermatology & Cosmetics Laser Care a Medical Corporation

  • Specialist
  • Valencia, CA
  • NPI 1912026097

  Dermatology

  Medicare reassignment NPD
• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment NPD
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment NPD
• Willett Medical Group

  • Dermatology Physician
  • Encinitas, CA
  • NPI 1124951082
  NPD Authorized official
• Compass Dermatopathology, Inc.

  dba SkyMD

  • Dermatopathology Physician
  • San Diego, CA
  • NPI 1922312248

  NM

  Medicare reassignment
• K. D. Macknet, M.D., Inc.

  dba Loma Linda Dermatology Medical Group

  • Dermatology Physician
  • Loma Linda, CA
  • NPI 1083791644
  NPD
• Scripps Health

  dba Scripps Home Health Care Services

  • Home Health Agency
  • San Diego, CA
  • NPI 1578556114
  NPD
• Timothy F. Richardson, M.D., a Medical Corporation

  dba Mirage Dermatology Medical Associates, Inc.

  • Medical Specialty Clinic/Center
  • Palm Desert, CA
  • NPI 1346262375
  NPD
• David C Leech DO Inc PC

  • Adult Medicine Physician
  • Albuquerque, NM
  • NPI 1770724916
  NPD
• St Luke's Physician Group Inc

  dba St. Luke's Primary Care Orwigsburg

  • Family Medicine Physician
  • Orwigsburg, PA
  • NPI 1710845144
  NPD

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1720328107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-719-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CAMP PENDLETON",
            "address_2": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-719-3249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10820 N Torrey Pines Rd",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371036",
            "country_code": "US",
            "telephone_number": "858-554-8646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36867 Cook St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "922116064",
            "country_code": "US",
            "telephone_number": "760-341-1999",
            "fax_number": "760-341-1997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "MATTHEW",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-22",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "132174",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "132174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Andrew Pearce White
• Tommy Bernard White, DMD
• Trina Whiting, REGISTERED NURSE
• Lisa C Whitney, LCSW
• Russell P. Wier, D.O.
• Stephen Craig Williams, PA-C
• Virginia Santiago Williams, PROPHY TECH
• John Williamson, MD
• Emanuel Vance Willis, DMD
• Brandon James Wilmot, PA-C

• Dermatology Physician in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.