Dr Simon Matt Willis, MD is a medicare enrolled "Physical Medicine & Rehabilitation - Pain Medicine" physician in Pooler, Georgia. He graduated from medical school in 2014 and has 10 years of diverse experience with area of expertise as Physical Medicine And Rehabilitation. He is a member of the group practice Scl Health Medical Group - Grand Junction Llc and his current practice location is
114 Canal St Ste 503, Pooler, Georgia. You can reach out to his office (for appointments etc.) via phone at
(912) 450-6300.
Dr Simon Matt Willis is licensed to practice in Georgia (license number 84680) 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 1356761191.
Physician's Profile
| Full Name | Dr Simon Matt Willis |
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| Gender | Male |
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| Speciality | Physical Medicine And Rehabilitation |
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| Experience | 10 Years |
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| Location | 114 Canal St Ste 503, Pooler, Georgia |
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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 Simon Matt Willis graduated from medical school in 2014
NPI Data:
- NPI Number: 1356761191
- Provider Enumeration Date: 04/20/2014
- Last Update Date: 04/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 3476805060
- Enrollment ID: I20190806001655
Medical Identifiers
Medical identifiers for Dr Simon Matt Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1356761191 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 83377 (South Carolina) | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 84680 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Scl Health Medical Group - Grand Junction Llc | 3779707856 | 207 |
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 Simon Matt Willis allows following entities to bill medicare on his behalf.
| Entity Name | Scl Health Medical Group - Grand Junction Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356765556
PECOS PAC ID: 3779707856
Enrollment ID: O20140611000363 |
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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 Simon Matt 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 Simon Matt Willis, MD
114 Canal St Ste 503,
Pooler, GA 31322-4261
Ph: (912) 450-6300 | Dr Simon Matt Willis, MD
114 Canal St Ste 503,
Pooler, GA 31322-4261
Ph: (912) 450-6300 |
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