JEREMY DAVID WILLES (PAC) – Physician Assistant, NPI 1356314843

JEREMY DAVID WILLES (PAC) is a healthcare provider. based in Twin falls, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. PA638 (ID). The NPI Number for JEREMY DAVID WILLES (PAC) is 1356314843

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
JEREMY DAVID WILLES (PAC)
NPI
1356314843
Phone
(208) 736-7422
Address
260 FALLS AVE
Enumeration Date
7 February 2006
Last Update Date
8 May 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2087367422
Graduation Year
2003 (23 years ago)
PAC ID
4981660115
Group Practice PAC ID
0143460717
Professional Enrollment ID
I20090302000293
Address ID
ID833014278TW243XXWXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,534 PHYSICIAN ASSISTANT in ID

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Provider Addresses for JEREMY DAVID WILLES (PAC)

  • Physicians Immediate Care Center, 260, Falls Avenue, Twin Falls, Twin Falls County, Idaho, 83301, United States

    SUITE C

    TWIN FALLS, ID 833013370

    Phone: (208) 736-7422

    Fax: (208) 736-8905

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-03-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090302000293IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes8274$0
99212Established patient office or other outpatient visit, 10-19 minutes3530$0
99203New patient office or other outpatient visit, 30-44 minutes2222$0
87430Detection test by immunoassay technique for streptococcus, group a (strep)2019$0
87428Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza1818$0
View full utilization report →

Insurance plans in this area (ZIP 83301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0143460717View full group profile
NameSpecialtyState
Emergency MedicineID
Physician AssistantID
-ID

Reviews

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Frequently asked questions

What is the registry number for JEREMY DAVID WILLES (PAC)?
The registry entry for JEREMY DAVID WILLES (PAC) shows NPI 1356314843.
Is JEREMY DAVID WILLES (PAC)'s NPI status active today?
Active status means JEREMY DAVID WILLES (PAC)'s NPI record is not deactivated in the public file.
What services align with JEREMY DAVID WILLES (PAC)'s listing?
JEREMY DAVID WILLES (PAC)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JEREMY DAVID WILLES (PAC)?
JEREMY DAVID WILLES (PAC) is associated with Twin Falls, Idaho in the same public data insurers reference.
Can I export JEREMY DAVID WILLES (PAC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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