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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TIMOTHY JOHN WILLIS DO
NPI 1508561952
Student in an Organized Health Care Education/Training Program in Albuquerque, NM

Active since April 04, 2023PECOS Enrolled
MSC10 5590 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 81731(505) 272-2345(505) 272-2374 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2026, Mar 5, 2026, Apr 4, 2023 (3 updates tracked since 2023).

About Timothy John Willis Do NPPES

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

TIMOTHY JOHN WILLIS DO (NPI 1508561952) is an individual student in an organized health care education/training program in Albuquerque, New Mexico and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Tucson.

NPPES Registry Identity

NPI1508561952
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTIMOTHY JOHN WILLISCredential: DO
Location AddressMSC10 5590 1 UNIVERSITY OF NEW MEXICOAlbuquerque, NM 81731-0001
Mailing Address2130 N Star Glory PlTucson, AZ 85715-6815
Phone(505) 272-2345
Fax(505) 272-2374
Sole ProprietorNo
Enumeration DateApril 4, 2023
Last NPPES UpdateJuly 13, 20263 updates tracked since enumeration
NPPES CertifiedJuly 13, 2026
✔ NPI 1508561952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
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.
MSC10 5590 1 UNIVERSITY OF NEW MEXICO, Albuquerque, NM 81731
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Secondary Practice Location 1

Location 15301 E Grant RdTucson, AZ 85712-2805 · Phone (520) 324-5096

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy John Willis Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 Timothy Willis's NPI number?

The NPI number for Timothy Willis is 1508561952. It was assigned to this individual provider in the NPPES registry on April 4, 2023.

Where is Timothy Willis located?

Timothy Willis practices at Msc10 5590 1 University Of New Mexico, Albuquerque, NM 81731. The listed phone number is (505) 272-2345.

What is Timothy Willis's specialty?

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

Is Timothy Willis enrolled in Medicare?

Yes. Timothy Willis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Willis was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 31 days 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.