Individual provider Active NPI

Bennett Willis Bryant, PA

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1881322196
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007210 Issued in CO
Practice address
660 Bannock St # L
Denver, CO 80204-4506
Phone
(202) 436-6000
Fax
(303) 602-8505
NPI assigned
Aug 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0007210 CO Primary

Addresses

Primary practice location

660 Bannock St # L
Denver, CO 80204-4506

Mailing address

2285 Iris St
Lakewood, CO 80215-1657
Phone (828) 230-9618

Other names 1

  • Allison Bennett Willis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20220922002067 CO Practitioner - Physician Assistant 5698150951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
92.15
Promoting interoperability
100
Improvement activities
40
Cost
80.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0007210COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Sep 25, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 25, 2022 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
Ste MC3450
Denver, CO 80204

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: bbryant269827@direct.dhha.org

Organizations & group practices 3

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.

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": "1660348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1881322196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 IRIS ST",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802151657",
            "telephone_number": "828-230-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST # L",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "202-436-6000",
            "fax_number": "303-602-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "BENNETT",
        "middle_name": "WILLIS",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-13",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "WILLIS",
            "middle_name": "BENNETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.