Dr Randall J Willis, MD is a medicare enrolled "Urology" physician in Stillwater, Oklahoma. His current practice location is
801 S Walnut St, Stillwater, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(405) 743-3760.
Dr Randall J Willis is licensed to practice in Oklahoma (license number 12754) 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 1902860356.
Physician's Profile
| Full Name | Dr Randall J Willis |
|---|
| Gender | Male |
|---|
| Speciality | Urology |
|---|
| Location | 801 S Walnut St, Stillwater, Oklahoma |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1902860356
- Provider Enumeration Date: 04/13/2006
- Last Update Date: 02/01/2018
Medicare PECOS Information:
- PECOS PAC ID: 0648165431
- Enrollment ID: I20100915000654
Medical Identifiers
Medical identifiers for Dr Randall J Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902860356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | 12754 (Oklahoma) | 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. Dr Randall J Willis allows following entities to bill medicare on his behalf.
| Entity Name | Stillwater Medical Center Authority |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1558377135
PECOS PAC ID: 2365353794
Enrollment ID: O20040525001304 |
|---|
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 Randall J 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 |
|---|
Dr Randall J Willis, MD
801 S Walnut St,
Stillwater, OK 74074-4226
Ph: (405) 743-3760 | Dr Randall J Willis, MD
801 S Walnut St,
Stillwater, OK 74074-4226
Ph: (405) 743-3760 |
Reviews and Comments