WILLIAM JR. ENNIS (P.A.) – Surgical Physician Assistant, NPI 1407199706

WILLIAM JR. ENNIS (P.A.) is a healthcare provider. based in Salisbury, Maryland. specializing in Surgical Physician Assistant. They hold the professional credentials P.A.. They hold a License No. C05019 (MD). The NPI Number for WILLIAM JR. ENNIS (P.A.) is 1407199706

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
WILLIAM JR. ENNIS (P.A.)
NPI
1407199706
Phone
(410) 543-9332
Address
6507 DEER POINTE DR
Enumeration Date
4 April 2013
Last Update Date
30 May 2024

Doctor Profile

Medical School Name
UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE
Secondary Phone
4105437065
Graduation Year
2012 (14 years ago)
PAC ID
0941446553
Group Practice PAC ID
4284699406
Professional Enrollment ID
I20130425000617
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for WILLIAM JR. ENNIS (P.A.)

  • 6507 DEER POINTE DR

    SALISBURY, MD 218041667

    Phone: (410) 543-9332

    Fax: (410) 543-9237

    Type: Mailing

  • 914A EASTERN SHORE DR

    SALISBURY, MD 218046410

    Phone: (410) 546-1331

    Fax: (410) 543-8107

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 62 Open Payments records for all available years, with a total value of $1,201.

Total Amount is formed as General ($1,201) + Research ($0) + Ownership ($0) = $1,201.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: ABBVIE INC. ($227).

Total Amount

$1,201

General + Research + Ownership

Payments

62

Total payment records

General Amount

$1,201

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2013-04-25

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
I20130425000617IPhysician AssistantMDTBD

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 21804)

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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: 4284699406View full group profile
NameSpecialtyState
Physician AssistantPA
Physical Medicine And RehabilitationMD
Physician AssistantMD
Physical Medicine And RehabilitationMD
Physical Medicine And RehabilitationMD
Physician AssistantMD
Nurse PractitionerMD
Physician AssistantMD
Physical Medicine And RehabilitationNC

Reviews

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Frequently asked questions

What is the 10-digit NPI for WILLIAM JR. ENNIS (P.A.)?
WILLIAM JR. ENNIS (P.A.) — NPI 1407199706 — is the standard way to identify this listing.
Does the file indicate WILLIAM JR. ENNIS (P.A.) is practicing under active NPI?
Directory data currently reports WILLIAM JR. ENNIS (P.A.) as active.
What is WILLIAM JR. ENNIS (P.A.) best known for clinically?
Directory data describes WILLIAM JR. ENNIS (P.A.) with Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is WILLIAM JR. ENNIS (P.A.) based?
WILLIAM JR. ENNIS (P.A.) is tied to Salisbury, Maryland in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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