1. Home
  2. Directory
  3. California
  4. Santa Rosa
  5. Nurse Practitioner
  6. NPI Profile

WILLIE SLY PMHNP-BC
NPI 1053166199
Nurse Practitioner - Psychiatric/Mental Health in Santa Rosa, CA

Active since April 22, 2024PECOS Enrolled
2448 GUERNEVILLE RD STE 800, SANTA ROSA, CA 95403(707) 772-7522 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 5, 2026, Mar 18, 2026, Mar 11, 2026 and 2 more (5 updates tracked since 2024).

About Willie Sly Pmhnp-bc NPPES

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

WILLIE SLY PMHNP-BC (NPI 1053166199) is an individual psychiatric/mental health provider in Santa Rosa, California, licensed in California (95038910) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1053166199
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameWILLIE SLYCredential: PMHNP-BC
Location Address2448 GUERNEVILLE RD STE 800Santa Rosa, CA 95403-7228
Mailing Address2448 Guerneville Rd Ste 800Santa Rosa, CA 95403-7228 · (707) 772-7522
Phone(707) 772-7522
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 22, 2024
Last NPPES UpdateMay 5, 20265 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1053166199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in CA · 95038910✔ Licensed in ID · 5971891
2448 GUERNEVILLE RD STE 800, Santa Rosa, CA 95403
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, PacificSource Health Plans, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Willie Sly Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264905355
PECOS Enrollment IDI20260619001366
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.

Medicare Billing Reassignment

Medicare enrollment records show Willie Sly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Torrico Medical Group Inc
Same address
Psychiatry
2448 GUERNEVILLE RD STE 800
Santa Rosa, CA 95403
  • Reassigned Medicare billing, California enrollment
  • 22 clinicians in this Medicare group
NPI 1033926480 (707) 800-7744

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.16 typical visit price
range $63.04 – $187.01
Typical copayment $24.04 (range $15.76 – $46.75)
Most-billed visit code 99203
Established Patient
$109.88 typical visit price
range $21.02 – $153.40
Typical copayment $27.47 (range $5.25 – $38.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

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

TORRICO MEDICAL GROUP INC
Psychiatry & Neurology (Psychiatry)
2448 GUERNEVILLE RD STE 800
SANTA ROSA, CA 95403
Sonoma County (707) 800-7744
DR. MORKEH BLAY-TOFEY MD, MBA
Psychiatry & Neurology (Psychiatry)
2448 GUERNEVILLE RD STE 800
SANTA ROSA, CA 95403
Sonoma County (801) 682-6148
CASEY CHARLEY BLAIR CHARLEY RN
Nurse Practitioner (Psychiatric/Mental Health)
2448 GUERNEVILLE RD STE 800
SANTA ROSA, CA 95403
Sonoma County (707) 800-7744
DR. SOPHIA DHILLON MD
Psychiatry & Neurology (Psychiatry)
2448 GUERNEVILLE RD STE 800
SANTA ROSA, CA 95403
Sonoma County (707) 800-7744
SHREY NINAD PATEL MD
Psychiatry & Neurology (Psychiatry)
2448 GUERNEVILLE RD STE 800
SANTA ROSA, CA 95403
Sonoma County (707) 772-7522

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willie Sly's NPI number?

The NPI number for Willie Sly is 1053166199. It was assigned to this individual provider in the NPPES registry on April 22, 2024.

Where is Willie Sly located?

Willie Sly practices at 2448 Guerneville Rd Ste 800, Santa Rosa, CA 95403. The listed phone number is (707) 772-7522.

What is Willie Sly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Willie Sly enrolled in Medicare?

Yes. Willie Sly is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Willie Sly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Willie Sly reassigns Medicare benefits to Torrico Medical Group Inc (Santa Rosa, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Willie Sly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Willie Sly accept?

Health plans from Molina Healthcare, PacificSource Health Plans and Select Health list Willie Sly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Willie Sly was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.