Brian Wesley Willis, AGPCNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95032580 Issued in CA

Practice address

555 E Tachevah Dr Ste 2W101
Palm Springs, CA 92262-5748

Phone

(760) 320-6005

Fax

(760) 323-5786

NPI assigned

Dec 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Springs Urology Medical Group PCGroup PAC ID 5597289330, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Palm Springs Urology Medical Group, P.C.

  • Urology Physician
  • Palm Springs, CA
  • NPI 1578386579
  Medicare reassignment Care Compare group NPD
• Brad a Wolfson M D a Medical Corporation

  • Urology Physician
  • Palm Springs, CA
  • NPI 1912232166
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Eisenhower Medical Center

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1841007127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 BRASSIE PL",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922646339",
            "telephone_number": "323-747-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR STE 2W101",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625748",
            "telephone_number": "760-320-6005",
            "fax_number": "760-323-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BRIAN",
        "middle_name": "WESLEY",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95032580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Williams, PHARMD
• Eugene Williams
• Kimberly Williams
• Sugi Utama Williams, MSN, FNP-C, FNP-BC
• Yolanda Williams, AMFT
• Willow Tree Hospice Inc
• David Richard Wilson, PT
• Debra Kay Wilson, AMFT
• Jo Ann Wilson
• Kristi Ann Wilson, RN

• Primary Care Nurse Practitioner in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.