Dr Chad D Willis, DO - Medicare Otolaryngology in Shawnee, OK

Dr Chad D Willis, DO is a medicare enrolled "Otolaryngology - Plastic Surgery Within The Head & Neck" physician in Shawnee, Oklahoma. He graduated from medical school in 2005 and has 19 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Shawnee Medical Center Clinic, Inc. and his current practice location is 3214 Kethley Rd, Shawnee, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (405) 273-5801.

Dr Chad D Willis is licensed to practice in Oklahoma (license number 4875) 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 1750432043.

Contact Information

Dr Chad D Willis, DO
3214 Kethley Rd,
Shawnee, OK 74804-9625
(405) 273-5801
(405) 878-3794



Physician's Profile

Full NameDr Chad D Willis
GenderMale
SpecialityOtolaryngology
Experience19 Years
Location3214 Kethley Rd, Shawnee, Oklahoma
Accepts Medicare AssignmentsYes. 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 Chad D Willis graduated from medical school in 2005
  NPI Data:
  • NPI Number: 1750432043
  • Provider Enumeration Date: 01/15/2007
  • Last Update Date: 11/11/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 9830288604
  • Enrollment ID: I20100805001071

Medical Identifiers

Medical identifiers for Dr Chad D Willis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750432043NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 2006033639 (Missouri)Secondary
207YX0007XOtolaryngology - Plastic Surgery Within The Head & Neck 4875 (Oklahoma)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ssm Health St Anthony Hospital - ShawneeShawnee, OKHospital
Ssm Health St Anthony Hospital - Oklahoma CityOklahoma city, OKHospital
O U Medical CenterOklahoma city, OKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Shawnee Medical Center Clinic, Inc.387040543480

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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 Chad D Willis allows following entities to bill medicare on his behalf.
Entity NameShawnee Medical Center Clinic, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881648285
PECOS PAC ID: 3870405434
Enrollment ID: O20031103000239

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Entity NamePurcell Municipal Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1467476911
PECOS PAC ID: 7719899400
Enrollment ID: O20031106000100

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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. Dr Chad D 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
Dr Chad D Willis, DO
Po Box 258884,
Oklahoma City, OK 73125-8884

Ph: (405) 231-3857
Dr Chad D Willis, DO
3214 Kethley Rd,
Shawnee, OK 74804-9625

Ph: (405) 273-5801

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Otolaryngology Doctors in Shawnee, OK

Dr. Craig X Summers, M.D.
Otolaryngology
Medicare: Not Enrolled in Medicare
Practice Location: 1102 W Macarthur St, Shawnee, OK 74804
Phone: 405-878-8183    Fax: 405-878-8101

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