| James L Willis, DO | |
|
1741 David Walker Dr, Tavares, FL 32778-5745 | |
| (352) 742-8836 | |
| (352) 742-8829 |
| Full Name | James L Willis |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 28 Years |
| Location | 1741 David Walker Dr, Tavares, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154322915 | NPI | - | NPPES |
| 268324500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS8915 (Florida) | Secondary |
| 208M00000X | Hospitalist | OS8915 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Adventhealth Waterman | Tavares, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Florida Hospital Healthcare Partners, Inc | 7012266836 | 510 |
| Entity Name | Central Florida Hospitalist Partners Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558381921 PECOS PAC ID: 5799689931 Enrollment ID: O20031120000518 |
| Entity Name | Central Florida Inpatient Medicine Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649228859 PECOS PAC ID: 7911805254 Enrollment ID: O20031223000824 |
| Entity Name | Inpatient Consultants Of Florida, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396795597 PECOS PAC ID: 4789614785 Enrollment ID: O20050819000018 |
| Entity Name | Pioneer Medical Group Pl |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710315775 PECOS PAC ID: 8224266655 Enrollment ID: O20140110000843 |
| Entity Name | Florida Hospital Healthcare Partners, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780100529 PECOS PAC ID: 7012266836 Enrollment ID: O20180831000335 |
| Entity Name | Ridgewood Physician Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295216034 PECOS PAC ID: 0446594105 Enrollment ID: O20181206001200 |
| Mailing Address | Practice Location Address |
|---|---|
| James L Willis, DO 1741 David Walker Dr, Tavares, FL 32778-5745 Ph: (352) 742-8836 | James L Willis, DO 1741 David Walker Dr, Tavares, FL 32778-5745 Ph: (352) 742-8836 |
Dr. Shaik Ejazuddin, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1741 David Walker Dr, Tavares, FL 32778 Phone: 352-742-8836 | |
Sameh Nazeeh Adly Mohareb, MD, M.B.,BCH. Hospitalist Medicare: Not Enrolled in Medicare Practice Location: 1825 Salk Ave, Tavares, FL 32778 Phone: 352-343-1158 | |
Jessica Nicole Mastrapa, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1000 Waterman Way, Tavares, FL 32778 Phone: 352-742-3578 Fax: 352-742-3581 |