Kerry C Willis, CRNP - Medicare Nurse Practitioner in Hazleton, PA

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Kerry C Willis, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Hazleton, Pennsylvania. His current practice location is 57 W Juniper St, Hazleton, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (570) 501-1017.

Kerry C Willis is licensed to practice in Pennsylvania (license number TP007004B) 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 1295701266.

Contact Information

Kerry C Willis, CRNP
57 W Juniper St,
Hazleton, PA 18201-6410
(570) 501-1017
(570) 501-2695

Map and Direction




Provider's Profile

Full NameKerry C Willis
GenderMale
SpecialityNurse Practitioner - Family
Location57 W Juniper St, Hazleton, Pennsylvania
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1295701266
  • Provider Enumeration Date: 02/28/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 5496795494
  • Enrollment ID: I20050510000225

Medical Identifiers

Medical identifiers for Kerry C Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295701266NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family TP007004B (Pennsylvania)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. Kerry C Willis allows following entities to bill medicare on his behalf.
Entity NamePinnacle Health Emergency Department Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487693404
PECOS PAC ID: 0143124701
Enrollment ID: O20031125000218
Entity NameLehigh Valley Physician Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457309650
PECOS PAC ID: 3072425123
Enrollment ID: O20040227000335
Entity NameAtlantic Physician Services Of Maryland, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730129594
PECOS PAC ID: 5193619765
Enrollment ID: O20040504000401
Entity NameEmergency Care Services Of Pennsylvania Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114955010
PECOS PAC ID: 1759301799
Enrollment ID: O20051206000046
Entity NamePennsylvania Physician Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497059802
PECOS PAC ID: 1153507025
Enrollment ID: O20110511000343

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. Kerry C 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 AddressPractice Location Address
Kerry C Willis, CRNP
27 8th St,
Ringtown, PA 17967-9409

Ph: (570) 578-6174		Kerry C Willis, CRNP
57 W Juniper St,
Hazleton, PA 18201-6410

Ph: (570) 501-1017

Reviews and Comments


Nurse Practitioner Nurses in Hazleton, PA

Mrs. Heather Ortiz, MSN, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 700 E Broad St, Hazleton, PA 18201
Phone: 570-501-4193    
Scott Joseph Adams, CRNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 700 E Broad St, Hazleton, PA 18201
Phone: 570-501-4000    
Mrs. Sharon Susan Forlenza-stevens, RN,CRNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 10 W Chestnut St, Ste 6, Hazleton, PA 18201
Phone: 570-501-2941    Fax: 570-501-1194
Patricia Rosati, CRNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1740 E Broad St, Hazleton, PA 18201
Phone: 570-459-2901    
Laurie D Karahoca, CRNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 700 E Broad St, Hazleton, PA 18201
Phone: 570-501-4000    
Rachel Barletta-scarcella,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 700 E Broad St, Hazleton, PA 18201
Phone: 570-501-4193    Fax: 570-501-4109

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.