MATTHEW M WILLIS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1033770607

MATTHEW M WILLIS (CRNA) is a healthcare provider. based in Waterloo, Iowa. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. D155119 (IA). The NPI Number for MATTHEW M WILLIS (CRNA) is 1033770607

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
MATTHEW M WILLIS (CRNA)
NPI
1033770607
Phone
(319) 235-5390
Address
PO BOX 2758
Enumeration Date
25 June 2019
Last Update Date
10 March 2022

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
3192353941
Graduation Year
2019 (7 years ago)
PAC ID
0143555052
Group Practice PAC ID
1759291487
Professional Enrollment ID
I20190715003463
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

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Provider Addresses for MATTHEW M WILLIS (CRNA)

  • PO BOX 2758

    WATERLOO, IA 507042758

    Phone: (319) 235-5390

    Type: Mailing

  • Allen Hospital, 1825, Logan Avenue, Waterloo, Black Hawk County, Iowa, 50703, United States

    WATERLOO, IA 507031916

    Phone: (319) 235-5390

    Fax: (319) 233-1630

    Type: Location

  • 1229 C AVE E

    OSKALOOSA, IA 525774298

    Phone: (641) 672-3394

    Fax: (641) 672-3336

    Type: Mailing

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: 2022-11-14

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
I20221114002382ICertified Registered Nurse Anesthetist (Crna)IDTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 50704)

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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: 1759291487View full group profile

Reviews

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Frequently asked questions

Does MATTHEW M WILLIS (CRNA) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MATTHEW M WILLIS (CRNA) uses 1033770607.
Is MATTHEW M WILLIS (CRNA) listed as active for patients and plans?
The listing shows MATTHEW M WILLIS (CRNA) as active in the NPI system.
What is MATTHEW M WILLIS (CRNA)'s primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for MATTHEW M WILLIS (CRNA) here. Clinical services aligned with this taxonomy classification.
Where is MATTHEW M WILLIS (CRNA) based?
MATTHEW M WILLIS (CRNA) is tied to Waterloo, Iowa in the data we show; additional addresses may exist on the full record.
Is the information about MATTHEW M WILLIS (CRNA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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