TISHA WILLIS FNP
NPI 1275175069
Nurse Practitioner - Family in Minneapolis, MN

Q: What is Tisha Willis's NPI number?

The NPI number for Tisha Willis is 1275175069. It was assigned to this individual provider in the NPPES registry on October 13, 2019.

Q: What is Tisha Willis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tisha Willis was last updated on February 22, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 13, 2019PECOS EnrolledAccepts Medicare Assignment

2240 DREW AVE S, MINNEAPOLIS, MN 55416(952) 985-0747(952) 400-8802 Get Directions Write a Review

NPPES record last updated: February 22, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 2, 2025, Apr 13, 2023, Mar 29, 2023 and 1 more (4 updates tracked since 2019).

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About Tisha Willis Fnp NPPES

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

TISHA WILLIS FNP (NPI 1275175069) is an individual family provider in Minneapolis, Minnesota, licensed in Texas (AP144040) and active in the NPI registry since October 2019. She is enrolled in Medicare PECOS, is affiliated with White Rock Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1275175069

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTISHA WILLISCredential: FNP

Location Address2240 DREW AVE SMinneapolis, MN 55416-3646

Mailing Address2240 Drew Ave SMinneapolis, MN 55416-3646 · (952) 985-0747 · Fax (952) 400-8802

Phone(952) 985-0747

Fax(952) 400-8802

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateOctober 13, 2019

Last NPPES UpdateFebruary 22, 20264 updates tracked since enumeration

NPPES CertifiedFebruary 22, 2026

✔ NPI 1275175069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in TX · AP144040✔ Licensed in TX · F10190145

2240 DREW AVE S, Minneapolis, MN 55416

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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, UnitedHealthcare.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

Tisha Willis Fnp 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 ID8820469349

PECOS Enrollment IDI20230120000673

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 4

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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

72 services20 patients

Removal of skin and tissue, 20.0 sq cm or less 11042

This procedure involves the surgical removal of skin and tissue, up to 20.0 square cm in size. It's often performed to treat conditions like skin cancer or to remove moles, warts, and other skin lesions. The area is numbed and the unwanted tissue is carefully cut out.

55 services18 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

46 services15 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

32 services15 patients

Hospital Affiliations CMS Care Compare

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

White Rock Medical Center

Acute Care Hospitals · Dallas, TX

1/5 CMS rating

OwnershipProprietary

CMS Certification Number450678

Location9440 Poppy DriveDallas, TX 75218 · Dallas County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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.

WOUND COMPANY PROVIDER GROUP, P.A.

Registered Nurse (Wound Care)