Tony L. Willson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME97817 Issued in FL

Practice address

1310 County Road 210 W
St Johns, FL 32259-1183

Phone

(904) 824-4407

Fax

(904) 390-7459

NPI assigned

Oct 2, 2006

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, CO2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

Merit-based Incentive Payment System (MIPS)

Final score

95.44 of 100Reported as apm

Quality

84.21

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twilson182545@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  Medicare reassignment Care Compare group NPD
• Optumcare Colorado Medical Group LLC

  dba Optum Colorado Springs

  • General Practice Physician
  • Colorado Springs, CO
  • NPI 1407252828
  Medicare reassignment NPD
• New West Physicians Inc

  • Internal Medicine Physician
  • Golden, CO
  • NPI 1427010859
  Medicare reassignment
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD
• Optumcare Colorado Medical Group LLC

  dba Colorado Center for Arthritis & Osteoporosis

  • Rheumatology Physician
  • Boulder, CO
  • NPI 1922893478
  NPD
• Optumcare Colorado Medical Group, LLC

  dba ABC Pediatrics

  • Pediatrics Physician
  • Colorado Springs, CO
  • NPI 1548891815
  NPD

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

• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1982798310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 COUNTY ROAD 210 W",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322591183",
            "telephone_number": "904-824-4407",
            "fax_number": "904-390-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "TONY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0052091",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME97817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65779827",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Wiedel, MD
• Heather Wilkins
• Rachel Elizabeth Williams, BEHAVIOR TECHNICIAN
• Monica L Willis
• Willow Wellness Counseling
• Aurora Wilson, CPC
• Katherine Ann Wilson, PA-C
• Edward Steven Wygonik, O.D.
• Emily Wylie
• Sylvia Lyn Yarbrough, PA-C

• Family Medicine Physician in Saint Johns, FL
• Providers in Saint Johns, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.