NPIMap

Individual provider Active NPI

Peter L Willis, M.D.

  • Family Medicine Physician
  • Westerly, RI
National Provider Identifier
1730144551
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD10903 Issued in RI
Practice address
25 Wells St
Westerly, RI 02891-2922
Phone
(401) 596-8990
Fax
(401) 865-2393
NPI assigned
Apr 18, 2006
Last updated
Feb 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD10903 RI Primary

Addresses

Primary practice location

25 Wells St
Westerly, RI 02891-2922

Mailing address

20 York Street, CB-329
New Haven, CT 06510-3220
Phone (203) 688-1734

Other practice location 1

77 Franklin St
Westerly, RI 02891-3136
Phone (401) 596-6464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040513000081 RI Practitioner - Emergency Medicine 3577553577 Reassigns benefits to 3 organizations
I20200323003195 CT Practitioner - Emergency Medicine 3577553577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LMW Healthcare IncGroup PAC ID 7012155112, 24 clinicians

Practice addresses (Care Compare)

25 Wells St
Westerly, RI 02891-2922
Phone (401) 586-6000

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence and Memorial Hospital, Inc. Family Medicine CurrentSince Feb 5, 2020 Accepting new patients
Lawrence and Memorial Hospital, Inc. CurrentSince Feb 5, 2020 Accepting new patients
Pathology Consultants of New London, P.C. Current Accepting new patients
Emergency Physician Associates of New England PC CurrentSince Jan 1, 2010 Accepting new patients
LMW Healthcare Inc. Family Medicine CurrentSince Feb 3, 2020 Accepting new patients
Emergency Care Services of New England PC CurrentSince Jan 1, 2017 Accepting new patients
LMW Healthcare Inc. CurrentSince Feb 3, 2020 Accepting new patients
Rhode Island Emergency Physicians Past Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: pwillis451820@direct.ynhh.org

Organizations & group practices 8

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 3

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1730144551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-329",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-1734",
            "fax_number": "475-246-9106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WELLS ST",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028912922",
            "telephone_number": "401-596-8990",
            "fax_number": "401-865-2393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Franklin St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028913136",
            "country_code": "US",
            "telephone_number": "401-596-6464",
            "fax_number": "401-348-8660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "PETER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD10903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.