DR. JERROLD C WILLIS MD
NPI 1467407072
Radiology - Diagnostic Radiology in Mount Vernon, IL
About Dr. Jerrold C Willis Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JERROLD C WILLIS MD (NPI 1467407072) is an individual diagnostic radiology provider in Mount Vernon, Illinois, licensed in Illinois (36057038) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Heartland Regional Medical Center, and is a graduate of Southern Illinois University School Of Medicine (1977).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
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
Dr. Jerrold C Willis Md 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.
Medicare Billing Reassignments
5Medicare enrollment records show Jerrold Willis reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mount Vernon, IL 62864
- Reassigned Medicare billing, Illinois enrollment
- 15 clinicians in this Medicare group
Centralia, IL 62801
- Reassigned Medicare billing, Illinois enrollment
- Medicare enrollment name: St Marys Hospital Centralia Illinois
- 392 clinicians in this Medicare group
Flora, IL 62839
- Reassigned Medicare billing, Illinois enrollment
- 110 clinicians in this Medicare group
Newton, IL 62448
- Reassigned Medicare billing, Illinois enrollment
- Also billed through NPI 1265493720 (Illinois)
- 145 clinicians in this Medicare group
Olympia Fields, IL 60461
- Reassigned Medicare billing, Illinois enrollment
- 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.
Areas of Expertise CMS Part B claims 49
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.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Heartland Regional Medical Center
Acute Care Hospitals · Marion, ILCrossroads Community Hospital
Acute Care Hospitals · Mount Vernon, ILFairfield Memorial Hospital 1
Critical Access Hospitals · Fairfield, ILWabash General Hospital 1
Critical Access Hospitals · Mount Carmel, ILRed Bud Regional Hospital
Critical Access Hospitals · Red Bud, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62864 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
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.
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
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 Jerrold Willis's NPI number?
The NPI number for Jerrold Willis is 1467407072. It was assigned to this individual provider in the NPPES registry on May 23, 2006.
Where is Jerrold Willis located?
Jerrold Willis practices at 1 Good Samaritan Way Radiology Dept, Mount Vernon, IL 62864. The listed phone number is (618) 242-4600.
What is Jerrold Willis's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.
Is Jerrold Willis enrolled in Medicare?
Yes. Jerrold 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.
Which organizations bill Medicare for Jerrold Willis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jerrold Willis reassigns Medicare benefits to 5 organizations: Asbery And Associates Ob Gyn LLC (Mount Vernon, IL), St. Mary's Hospital, Centralia, Illinois (Centralia, IL), County Of Clay (Flora, IL), Crawford Hospital District (Newton, IL) and Specialists In Medical Imaging Sc (Olympia Fields, IL). Each 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 Jerrold Willis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Jerrold Willis affiliated with any hospitals?
According to CMS data, Jerrold Willis is affiliated with Heartland Regional Medical Center, Crossroads Community Hospital, Fairfield Memorial Hospital 1, Wabash General Hospital 1 and Red Bud Regional Hospital.
When was this NPI record last updated?
The NPPES record for Jerrold Willis was last updated on March 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.