MATTHEW DEAN WILLIS MD, MPH
NPI 1912125345
Psychiatry & Neurology - Child & Adolescent Psychiatry in Providence, RI

Q: What is Matthew Willis's NPI number?

The NPI number for Matthew Willis is 1912125345. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Q: What is Matthew Willis's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Willis was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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 April 23, 2007PECOS Enrolled

593 EDDY ST, POB 122, PROVIDENCE, RI 02903(401) 444-4515(401) 444-7018 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

On this page

About Matthew Dean Willis Md, Mph NPPES

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

MATTHEW DEAN WILLIS MD, MPH (NPI 1912125345) is an individual child & adolescent psychiatry provider in Providence, Rhode Island, licensed in Rhode Island (MD13403) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and maintains a secondary practice location in Riverside.

NPPES Registry Identity

NPI1912125345

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameMATTHEW DEAN WILLISCredential: MD, MPH

Location Address593 EDDY ST, POB 122Providence, RI 02903-4923

Mailing Address593 Eddy St, Potter 3Providence, RI 02903-4923 · (401) 444-4318 · Fax (401) 444-6573

Phone(401) 444-4515

Fax(401) 444-7018

Sole ProprietorNo

Enumeration DateApril 23, 2007

Last NPPES UpdateMarch 12, 2026

NPPES CertifiedMarch 12, 2026

✔ NPI 1912125345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in RI · MD13403

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPediatricsTaxonomy 208000000X · License MD13403 (RI)

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License MD13403 (RI)

593 EDDY ST, Providence, RI 02903

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Secondary Practice Location 1

Location 11011 Veterans Memorial PkwyRiverside, RI 02915-5061 · Phone (401) 432-1000 · Fax (401) 432-1500

Other Identifiers 1

OtherMD13403RI · Medical License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Matthew Dean Willis Md, Mph 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.

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.

DR. KEITH-AUSTIN SCARFO D.O.

Anesthesiology

593 EDDY ST, APC 6
PROVIDENCE, RI 02903

Providence County (401) 444-3777

AILEEN HSUEH

Surgery

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-8450

RHODE ISLAND HOSPITAL

General Acute Care Hospital

593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903

Providence County (401) 444-7585

DR. GA HIE NAM M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-5057

EUGENIE ATALLAH

Psychiatry & Neurology (Neurology)

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-2645

BRIAN CAO MD

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 606-4286

BRET CAULFIELD

Physician Assistant

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 444-4000

JUNG HO GONG

Student in an Organized Health Care Education/Training Program

593 EDDY ST
PROVIDENCE, RI 02903

Providence County (401) 793-2695

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 Matthew Willis's NPI number?

The NPI number for Matthew Willis is 1912125345. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Matthew Willis located?

Matthew Willis practices at 593 Eddy St Pob 122, Providence, RI 02903. The listed phone number is (401) 444-4515.

What is Matthew Willis's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Matthew Willis enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Matthew Willis was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.