IMANI MICHAELA WILLIAMS MD
NPI 1053059782
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since May 23, 2022PECOS Enrolled
840 WALNUT ST STE 920, PHILADELPHIA, PA 19107(215) 928-3000 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Imani Michaela Williams Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMANI MICHAELA WILLIAMS MD (NPI 1053059782) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Massachusetts Medical School (2022).

NPPES Registry Identity

NPI1053059782
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameIMANI MICHAELA WILLIAMSCredential: MD
Location Address840 WALNUT ST STE 920Philadelphia, PA 19107-5180
Mailing Address840 Walnut St Ste 920Philadelphia, PA 19107-5180
Sole ProprietorNo
Medical School CMSUniversity Of Massachusetts Medical SchoolGraduated 2022
Enumeration DateMay 23, 2022
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
NPI 1053059782 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

840 WALNUT ST STE 920, Philadelphia, PA 19107

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Imani Michaela Williams Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921475112
PECOS Enrollment IDI20260521002297
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107
Ophthalmology
840 WALNUT ST STE 920
PHILADELPHIA, PA 19107

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053059782, enumerated as an "individual" on May 23, 2022.

The provider is located at 840 WALNUT ST STE 920 PHILADELPHIA, PA 19107 and the phone number is (215) 928-3000.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.