Willie Sellers, AGACNP-BC - Medicare Nurse Practitioner in Surprise, AZ

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Willie Sellers, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Gerontology" in Surprise, Arizona. His current practice location is 15354 W Charter Oak Rd, Surprise, Arizona. You can reach out to his office (for appointments etc.) via phone at (843) 616-4948.

Willie Sellers is licensed to practice in Arizona (license number 248870) 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 1154928463.

Contact Information

Willie Sellers, AGACNP-BC
15354 W Charter Oak Rd,
Surprise, AZ 85379-9184
(843) 616-4948
Not Available

Map and Direction




Provider's Profile

Full NameWillie Sellers
GenderMale
SpecialityNurse Practitioner - Gerontology
Location15354 W Charter Oak Rd, Surprise, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1154928463
  • Provider Enumeration Date: 10/08/2020
  • Last Update Date: 10/08/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 8325450018
  • Enrollment ID: I20201222002469

Medical Identifiers

Medical identifiers for Willie Sellers such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154928463NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 248870 (Arizona)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. Willie Sellers allows following entities to bill medicare on his behalf.
Entity NameSouthwest Diagnostic Imaging Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1902896236
PECOS PAC ID: 7416946199
Enrollment ID: O20040507001294
Entity NameBanner - University Hospital Based Physicians Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750751566
PECOS PAC ID: 1052614294
Enrollment ID: O20160122000508
Entity NameBanner Imaging Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770139958
PECOS PAC ID: 1850724386
Enrollment ID: O20191213001312
Entity NameSonoran Radiology Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033745708
PECOS PAC ID: 3375964505
Enrollment ID: O20200526002412

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. Willie Sellers 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
Willie Sellers, AGACNP-BC
15354 W Charter Oak Rd,
Surprise, AZ 85379-9184

Ph: () -		Willie Sellers, AGACNP-BC
15354 W Charter Oak Rd,
Surprise, AZ 85379-9184

Ph: (843) 616-4948

Reviews and Comments


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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.