Active NPI
Mavis Williams Billips, M.D.
- Specialist
- Los Angeles, CA
National Provider Identifier
1902905664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A051005
- Practice address
- 8631 W 3Rd St
Suite 1135 E
Los Angeles, CA 90048-5901 - Phone
- (310) 651-8240
- Fax
- (310) 651-8254
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A051005 | CA | Primary |
Addresses
Primary practice location
8631 W 3Rd St
Suite 1135 E
Los Angeles, CA 90048-5901
Mailing address
4712 Admiralty Way
Suite 665
Marina del Rey, CA 90292-6905
Phone (310) 678-2686
Other names 1
- Dr. Mavis Theodora Williams
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050819000399 | CA | Practitioner - Dermatology | 4284664129 |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Warren Alpert Medical School of Brown University, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4712 Admiralty Way
Suite 665
Marina del Rey, CA 90292-6905
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51005 | CA | MD | General Practice Dentistry |
| A051005 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cedars-Sinai Medical Center | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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-
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- NPI 1992103188
-
- General Acute Care Hospital
- Los Angeles, CA
- NPI 1639172372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902905664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4712 ADMIRALTY WAY",
"address_2": "SUITE 665",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926905",
"telephone_number": "310-678-2686",
"fax_number": "310-651-8254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8631 W 3RD ST",
"address_2": "SUITE 1135 E",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900485901",
"telephone_number": "310-651-8240",
"fax_number": "310-651-8254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BILLIPS",
"first_name": "MAVIS",
"middle_name": "WILLIAMS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A051005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MAVIS",
"last_name": "WILLIAMS",
"middle_name": "THEODORA",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.