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JACK K WILLIS JR. PA
NPI 1063664183
Physician Assistant in Odessa, TX

Active since October 21, 2008PECOS EnrolledAccepts Medicare Assignment
4060 MEDICAL PARK DR # A, ODESSA, TX 79765(432) 582-2882(432) 582-2884 Get Directions Write a Review

NPPES record last updated: December 12, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jack K Willis Jr. Pa NPPES

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

JACK K WILLIS JR. PA (NPI 1063664183) is an individual physician assistant in Odessa, Texas, licensed in Texas (PA05950) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS, is affiliated with Medical Center Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1063664183
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACK K WILLIS JR.Credential: PA
Location Address4060 MEDICAL PARK DR # AOdessa, TX 79765-2233
Mailing Address4060 Medical Park DrOdessa, TX 79765-2233 · (432) 582-2882 · Fax (432) 582-2884
Phone(432) 582-2882
Fax(432) 582-2884
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateOctober 21, 2008
Last NPPES UpdateDecember 12, 2025
NPPES CertifiedDecember 12, 2025
✔ NPI 1063664183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA05950
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4060 MEDICAL PARK DR # A, Odessa, TX 79765
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack K Willis Jr. Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062574288
PECOS Enrollment IDI20081223000268
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, dexamethasone sodium phosphate, 1 mg J1100
Dexamethasone sodium phosphate is a medication given via injection. It is a type of steroid that helps reduce inflammation and immune responses. It can be used to treat a variety of conditions, such as allergies, skin conditions, arthritis, and more.
245 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
122 services116 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
57 services54 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
49 services49 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
42 services42 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
33 services31 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Medical Center Hospital

Acute Care Hospitals · Odessa, TX
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450132
Location500 W 4th StreetOdessa, TX 79761 · Ector County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79765 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
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jack Willis's NPI number?

The NPI number for Jack Willis is 1063664183. It was assigned to this individual provider in the NPPES registry on October 21, 2008.

Where is Jack Willis located?

Jack Willis practices at 4060 Medical Park Dr # A, Odessa, TX 79765. The listed phone number is (432) 582-2882.

What is Jack Willis's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jack Willis enrolled in Medicare?

Yes. Jack Willis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Willis accept?

Health plans from Blue Cross and Blue Shield of Texas list Jack Willis 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.

Is Jack Willis affiliated with any hospitals?

According to CMS data, Jack Willis is affiliated with Medical Center Hospital.

When was this NPI record last updated?

The NPPES record for Jack Willis was last updated on December 12, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.