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Dr. Austin Glenn Willis , DO

Pediatrics β€’ Albuquerque, NM

Active NPI 1083034920 Individual Practitioner Male Practitioner
Practice location in NPPES

1100 Central Ave Se
Albuquerque, NM 871064930

Call 5058411063 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1100 Central Ave Se

Albuquerque, NM 871064930

Telephone 5058411063
Organization at the Same NPPES Address or Phone
Anesthesia Associates Of New Mexico P C Facility NPI 1912900754

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Willis has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Willis as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Albuquerque and New Mexico

247 active clinicians are listed under Pediatrics with a practice address in Albuquerque, NM (453 in New Mexico).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Albuquerque

0% of these 247 clinicians have the CMS telehealth indicator.

8.1% of these 247 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES NM A-2075-17

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

License # reported to NPPES TX BP1-0059381

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: New Mexico State Medical Licensing Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
32103778 (NM)

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20170929001296

Enrollment State Jurisdiction

NM

PECOS Control ID

7012282171

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. Taylor Wisner , DNP, FNP-C, CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1558951236

Doctor of Nursing Practice, Family Nurse Practitioner (Certified), CPNPPC

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Pediatrics (license number reported to NPPES: TX BP1-0059381)

βœ…
NPI Profile Active September 08, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location September 08, 2017

Registered at 1100 CENTRAL AVE SE, ALBUQUERQUE, NM 871064930 (Tel: 5058411063)

πŸ“
Updated Business Mailing Address September 08, 2017

Registered at PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 871256666 (Tel: (505) 923-6770)

πŸ‘€
Provider Name / Credentials Updated September 08, 2017

Recorded as AUSTIN WILLIS, DO

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2017

Pediatrics (license number reported to NPPES: NM A-2075-17)

βœ…
NPI Profile Active April 18, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 18, 2014

Registered at 4900 MUELLER BLVD SUITE 3S.066C, UT SOUTHWESTERN AUSTIN - DELL CHILDRENS MEDICAL CENTER, AUSTIN, TX 78723 (Tel: 5123240165)

πŸ“
Business Mailing Address (Initial Record) April 18, 2014

Registered at 4900 MUELLER BLVD SUITE 3S.066C, UT SOUTHWESTERN AUSTIN - DELL CHILDRENS MEDICAL CENTER, AUSTIN, TX 78723

πŸ‘€
Provider Name / Credentials (Initial Record) April 18, 2014

Recorded as AUSTIN WILLIS, DO

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2014

Pediatrics (license number reported to NPPES: TX BP1-0059381)

🟒
Initial NPI Registration & Enumeration April 18, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1083034920
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2014
Last Update: July 21, 2022
Sole Proprietor: No

Other Pediatrics Specialists in Albuquerque

All Pediatrics Specialists in Albuquerque

Mailing Address

Po Box 26666, Phs Provider Enrollment

Albuquerque, NM 871256666

Phone: 5059236770

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.