Individual provider Active NPI

Thomas G. Willett

  • Psychiatry Physician
  • Hawthorne, CA
National Provider Identifier
1740229483
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A22826 Issued in CA
Practice address
4477 W 118TH St
400
Hawthorne, CA 90250-2255
Phone
(310) 978-1214
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A22826 CA Primary

Addresses

Primary practice location

4477 W 118TH St
400
Hawthorne, CA 90250-2255

Mailing address

3521 Lomita Blvd Ste 103
Torrance, CA 90505-5041
Phone (310) 534-9131

Other identifiers 2

IdentifierTypeStateIssuer
00A228260MedicaidCA
A22826OtherCAMEDICAL BOARD OF CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080123000385 CA Practitioner - Psychiatry 2264514777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Geffen School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4477 W 118TH St
Suite 400
Hawthorne, CA 90250-2259
Phone (210) 978-0884

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A22826CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory Willett MD, a Professional Corporation Psychiatry CurrentSince Aug 5, 1977 Accepting new patients
Gardena Hospital LP Past Accepting new patients
Prime Healthcare Centinela, LLC Past Accepting new patients
Hubert M. Gulak M.D. Inc. Past Accepting new patients
St Francis Medical Center Past Accepting new patients

Locations

4477 W 118th St
Ste 400
Hawthorne, CA 90250
Phone (210) 978-0884

3521 Lomita Blvd
Ste 103
Torrance, CA 90505

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1740229483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 LOMITA BLVD STE 103",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055041",
            "telephone_number": "310-534-9131",
            "fax_number": "310-534-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 W 118TH ST",
            "address_2": "400",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502255",
            "telephone_number": "310-978-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A22826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A228260",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CA",
            "identifier": "A22826",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.