ELTON MICHAEL WILLIAMS JR.
NPI 1184287153
Student in an Organized Health Care Education/Training Program in Santa Clara, CA

Active since April 16, 2019PECOS EnrolledAccepts Medicare Assignment
710 LAWRENCE EXPY, SANTA CLARA, CA 95051(408) 851-3817 Get Directions Write a Review

NPPES record last updated: November 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 21, 2022, Feb 4, 2022, Apr 16, 2019 (3 updates tracked since 2019).

About Elton Michael Williams Jr. NPPES

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

ELTON MICHAEL WILLIAMS JR. (NPI 1184287153) is an individual student in an organized health care education/training program in Santa Clara, California and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1184287153
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameELTON MICHAEL WILLIAMS JR.
Location Address710 LAWRENCE EXPYSanta Clara, CA 95051-5173
Mailing Address710 Lawrence ExpySanta Clara, CA 95051-5173
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 16, 2019
Last NPPES UpdateNovember 21, 20223 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2022
✔ NPI 1184287153 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.
710 LAWRENCE EXPY, Santa Clara, CA 95051

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Elton Michael Williams Jr. 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 ID6800275975
PECOS Enrollment IDI20230419001118
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 Elton Williams reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Health Maintenance Organization
9100 ROSEDALE HWY
Bakersfield, CA 93312
  • Reassigned Medicare billing, California enrollment
  • 5,228 clinicians in this Medicare group

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

Other Providers at the Same Location NPPES 20

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

Nurse Practitioner (Family)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Student in an Organized Health Care Education/Training Program
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Dietitian, Registered
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Physical Therapist
710 LAWRENCE EXPY, DEPT. #174
SANTA CLARA, CA 95051
Podiatrist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Internal Medicine (Gastroenterology)
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Physical Therapist
710 LAWRENCE EXPY
SANTA CLARA, CA 95051
Obstetrics & Gynecology
710 LAWRENCE EXPY
SANTA CLARA, CA 95051

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 Elton Williams's NPI number?

The NPI number for Elton Williams is 1184287153. It was assigned to this individual provider in the NPPES registry on April 16, 2019.

Where is Elton Williams located?

Elton Williams practices at 710 Lawrence Expy, Santa Clara, CA 95051. The listed phone number is (408) 851-3817.

What is Elton Williams's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Elton Williams enrolled in Medicare?

Yes. Elton Williams 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.

Which organization bills Medicare for Elton Williams's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elton Williams reassigns Medicare benefits to Southern California Permanente Medical Group (Bakersfield, 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 Elton Williams's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Elton Williams was last updated on November 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.