Jordan Willis, is a medicare enrolled "Orthopaedic Surgery" physician in Emporia, Kansas. His current practice location is
1301 W 12th Ave Ste 105, Emporia, Kansas. You can reach out to his office (for appointments etc.) via phone at
(620) 340-6181.
Jordan Willis is licensed to practice in Kansas (license number 04-49597) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1982197364.
Physician's Profile
| Full Name | Jordan Willis |
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| Gender | Male |
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| Speciality | Orthopaedic Surgery |
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| Location | 1301 W 12th Ave Ste 105, Emporia, Kansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1982197364
- Provider Enumeration Date: 06/11/2018
- Last Update Date: 07/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 0547519084
- Enrollment ID: I20230622002529
Medical Identifiers
Medical identifiers for Jordan Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982197364 | NPI | - | NPPES |
| 30004648890002 | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207X00000X | Orthopaedic Surgery | 04-49597 (Kansas) | Primary |
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. Jordan Willis allows following entities to bill medicare on his behalf.
| Entity Name | Mississippi Sports Medicine & Orthopaedic Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568415560
PECOS PAC ID: 4981685310
Enrollment ID: O20040601000238 |
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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. Jordan 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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Jordan Willis,
1201 W 12th Ave,
Emporia, KS 66801-2504
Ph: (620) 343-6800 | Jordan Willis,
1301 W 12th Ave Ste 105,
Emporia, KS 66801
Ph: (620) 340-6181 |
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