BRIAN WILLIE – Surgical Physician Assistant, NPI 1154719144

BRIAN WILLIE is a healthcare provider. based in Holland, Michigan. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5601007254 (MI). The NPI Number for BRIAN WILLIE is 1154719144

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
BRIAN WILLIE
NPI
1154719144
Phone
(616) 396-5855
Address
370 N 120TH AVE
Enumeration Date
30 December 2014
Last Update Date
30 December 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2014 (12 years ago)
PAC ID
7618292079
Group Practice PAC ID
0941513303
Professional Enrollment ID
I20150206001589
Address ID
MI495463808GR5060XSEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

Provider Addresses for BRIAN WILLIE

  • 370 N 120TH AVE

    HOLLAND, MI 494242196

    Phone: (616) 396-5855

    Fax: (616) 396-5720

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $18.

Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.

Last reported payment date: 2024-10-14 • Largest payer in this snapshot: Gilead Sciences, Inc. ($18).

Total Amount

$18

General + Research + Ownership

Payments

1

Total payment records

General Amount

$18

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-14

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Gilead Sciences, Inc.$18
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: 2015-02-06

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
I20150206001589IPhysician AssistantMITBD

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 49424)

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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: 0941513303View full group profile
NameSpecialtyState
Physician AssistantMI
Sports MedicineMI
Sports Medicine, Family PracticeMI
Physician AssistantMI
Physician AssistantIL
Nurse PractitionerMI
N E U R O S U R G E R YIL
Physician AssistantMI
Internal MedicineMI
Physician AssistantMI

Reviews

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Frequently asked questions

Can I cross-check BRIAN WILLIE using NPI 1154719144?
NPI 1154719144 belongs to BRIAN WILLIE; compare other details if you need extra assurance.
Is BRIAN WILLIE shown as active in public data?
Registry records indicate BRIAN WILLIE maintains an active NPI.
What area of care is associated with BRIAN WILLIE?
BRIAN WILLIE's record emphasizes Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is BRIAN WILLIE located near Holland?
BRIAN WILLIE currently maps to Holland, Michigan in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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