Dr Emmett C Willis Iv, MD in Bloomington, IN - Medicare Emergency Medicine

Dr Emmett C Willis Iv, MD is a medicare enrolled "Emergency Medicine" physician in Bloomington, Indiana. He went to Duke University School Of Medicine and graduated in 1991 and has 33 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Wake Forest Emergency Providers and his current practice location is 601 W 2nd St, Bloomington, Indiana. You can reach out to his office (for appointments etc.) via phone at (812) 353-6821.

Dr Emmett C Willis Iv is licensed to practice in North Carolina (license number 2007-00783) 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 1730281650.

Contact Information

	Dr Emmett C Willis Iv, MD
	601 W 2nd St, Bloomington, IN 47403-2317
	(812) 353-6821
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Emmett C Willis Iv
Gender	Male
Speciality	Emergency Medicine
Experience	33 Years
Location	601 W 2nd St, Bloomington, Indiana
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Emmett C Willis Iv attended and graduated from Duke University School Of Medicine in 1991

NPI Data:

NPI Number: 1730281650
Provider Enumeration Date: 09/01/2006
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 9931197043
Enrollment ID: I20070924000787

Medical Identifiers

Medical identifiers for Dr Emmett C Willis Iv such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730281650	NPI	-	NPPES
01057781A	Other	IN	IN LICENSE
2007-00783	Other	NC	NC LICENSE
01057781B	Other	IN	CSR
200446520	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	2007-00783 (North Carolina)	Primary
207P00000X	Emergency Medicine	01057781A (Indiana)	Secondary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Watauga Medical Center	Boone, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Wake Forest Emergency Providers	7012819816	225

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 Emmett C Willis Iv allows following entities to bill medicare on his behalf.

Entity Name	Wake Forest University Health Sciences
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436

Entity Name	Wake Forest Emergency Providers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396216735 PECOS PAC ID: 7012819816 Enrollment ID: O20190312003619

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 Emmett C Willis Iv 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
Dr Emmett C Willis Iv, MD Medical Center Blvd, Winston Salem, NC 27157-0001 Ph: (336) 716-2255	Dr Emmett C Willis Iv, MD 601 W 2nd St, Bloomington, IN 47403-2317 Ph: (812) 353-6821

Reviews and Comments

Emergency Medicine Doctors in Bloomington, IN

Ronald C Jenson, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 4794 Red Oak Ln, Bloomington, IN 47401 Phone: 812-396-9620
Dr. Robert Stone, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 514 W 2nd St, Bloomington, IN 47403 Phone: 812-353-3719 Fax: 812-353-3713
Dr. Christina M Cabott, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 601 W 2nd St, Bloomington, IN 47403 Phone: 812-336-1690 Fax: 812-349-1325
Otar Datiashvili, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515 Fax: 812-353-9275
Dr. John Austin Lee, MD, MPH Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515 Fax: 812-353-9275
Dr. Carlyle George Langhorn Jr., M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2651 E Discovery Pkwy, Bloomington, IN 47408 Phone: 812-353-9515
Jonathan D Hart, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2605 E Creeks Edge Dr, Bloomington, IN 47401 Phone: 812-355-2300 Fax: 812-355-2316

Dr Emmett C Willis Iv, MD - Medicare Emergency Medicine in Bloomington, IN