DR. SAMUEL ANDERSEN WILLIS M.D.
NPI 1881045060
Emergency Medicine in Augusta, GA

Q: What is Samuel Willis's NPI number?

The NPI number for Samuel Willis is 1881045060. It was assigned to this individual provider in the NPPES registry on June 28, 2016.

Q: What is Samuel Willis's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Willis was last updated on July 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 28, 2016PECOS Enrolled

3651 WHEELER RD, AUGUSTA, GA 30909(706) 651-6080 Get Directions Write a Review

NPPES record last updated: July 22, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 22, 2022, Jun 28, 2016 (2 updates tracked since 2016).

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About Dr. Samuel Andersen Willis M.d. NPPES

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

DR. SAMUEL ANDERSEN WILLIS M.D. (NPI 1881045060) is an individual emergency medicine provider in Augusta, Georgia, licensed in Georgia (80520) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881045060

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameDR. SAMUEL ANDERSEN WILLISCredential: M.D.

Location Address3651 WHEELER RDAugusta, GA 30909-6426

Mailing AddressPo Box 3052Augusta, GA 30914-3052 · (762) 233-1939

Phone(706) 651-6080

Sole ProprietorYes

Enumeration DateJune 28, 2016

Last NPPES UpdateJuly 22, 20222 updates tracked since enumeration

NPPES CertifiedJuly 22, 2022

✔ NPI 1881045060 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in GA · 80520

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

3651 WHEELER RD, Augusta, GA 30909

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samuel Andersen Willis M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Samuel Willis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Acs Primary Care Physicians - Southeast PC

190 mi

Emergency Medicine

809 82ND PKWY
Myrtle Beach, SC 29572

Reassigned Medicare billing, Georgia enrollment
586 clinicians in this Medicare group

NPI 1861430555 (843) 692-1000

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30909 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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 20

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

AMBER DAWN TOULSON

Nurse Anesthetist, Certified Registered