Dr Chad D Willis, DO is a medicare enrolled "Otolaryngology - Plastic Surgery Within The Head & Neck" physician in Shawnee, Oklahoma. He went to Oklahoma State University College Of Osteopathic Medicine and graduated in 2005 and has 21 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Saints Medical Group, Llc and his current practice location is
3214 Kethley Rd, Shawnee, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(405) 273-5801.
Dr Chad D Willis is licensed to practice in Oklahoma (license number 4875) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1750432043.
Physician's Profile
| Full Name | Dr Chad D Willis |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Experience | 21 Years |
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| Location | 3214 Kethley Rd, Shawnee, Oklahoma |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Chad D Willis attended and graduated from Oklahoma State University College Of Osteopathic Medicine in 2005
NPI Data:
- NPI Number: 1750432043
- Provider Enumeration Date: 01/15/2007
- Last Update Date: 11/11/2016
Medicare PECOS Information:
- PECOS PAC ID: 9830288604
- Enrollment ID: I20100805001071
Medical Identifiers
Medical identifiers for Dr Chad D Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1750432043 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 2006033639 (Missouri) | Secondary |
| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 4875 (Oklahoma) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Saints Medical Group, Llc | 7012914898 | 430 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Chad D Willis allows following entities to bill medicare on his behalf.
| Entity Name | Saints Medical Group, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437195922
PECOS PAC ID: 7012914898
Enrollment ID: O20061109000189 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Chad D Willis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Chad D Willis, DO
Po Box 258884,
Oklahoma City, OK 73125-8884
Ph: (405) 231-3857 | Dr Chad D Willis, DO
3214 Kethley Rd,
Shawnee, OK 74804-9625
Ph: (405) 273-5801 |
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