Madelyn Willis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA18349 Issued in TX

Practice address

2010 W Katherine P Raines Rd Ste 300
Cleburne, TX 76033-7447

Phone

(432) 620-1120

NPI assigned

Aug 25, 2022

Sex

Female

Sole proprietor

Yes

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 TX, OK2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) Inc 169 clinicians

Chisholm Trail Orthopedics and Sports Medicine, LLLP 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Cleburne Hospital, Cleburne, TX, CCN 450148
• Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Oliver Street 5.01(a) Inc.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413

  OK

  Medicare reassignment Care Compare group NPD
• Chisholm Trail Orthopedics & Sports Medicine, LLLP

  • Orthopaedic Surgery Physician
  • Cleburne, TX
  • NPI 1821148032

  TX

  Medicare reassignment Care Compare group
• Chisholm Trail Orthopedics & Sports Medicine, LLLP

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1619675873
  NPD
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

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

• Texas Health Harris Methodist Hospital Cleburne

  • General Acute Care Hospital
  • Cleburne, TX
  • NPI 1396778064

  Hospital

  Care Compare affiliation
• Texas Health Harris Methodist Hospital Southwest Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1417980202

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1942929666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 LAIR LN",
            "city": "CANYON",
            "state": "TX",
            "postal_code": "790154222",
            "telephone_number": "806-418-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD STE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337447",
            "telephone_number": "432-620-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MADELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Lee Wilde, COTA
• Andrew Wilhite, RPH
• Brandon Williams, DPT
• David Eugene Williams, RPH
• Meaghan Williams, ATC, LAT
• Ashley Nicole Wilson, PT, DPT
• Gregory Stephan Wilson, MD
• Kasey Wilson, PT, DPT
• Tina Kay Witkowski-Kirkpatrick, D.C.
• Women'S Health Associates of Cleburne PLLC

• All providers in Cleburne, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.