JOHN RYAN WILLIS (MD) – Diagnostic Radiology Physician, NPI 1326095670

JOHN RYAN WILLIS (MD) is a healthcare provider. based in St louis, Missouri. specializing in DIAGNOSTIC RADIOLOGY, INTERVENTIONAL RADIOLOGY, NUCLEAR MEDICINE. They hold the professional credentials MD. They hold a License No. 36108723 (IL). The NPI Number for JOHN RYAN WILLIS (MD) is 1326095670

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
JOHN RYAN WILLIS (MD)
NPI
1326095670
Phone
(303) 465-0401
Address
MID AMERICA RADIOLOGY SC
Enumeration Date
30 May 2006
Last Update Date
15 March 2021

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3096718282
Graduation Year
1998 (28 years ago)
PAC ID
2567440175
Group Practice PAC ID
2163733544
Professional Enrollment ID
I20040709001422
Address ID
IL628648290MO17186LNXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,121 DIAGNOSTIC RADIOLOGY in IL

Provider Addresses for JOHN RYAN WILLIS (MD)

  • MID AMERICA RADIOLOGY SC

    PO BOX 66971 DEPT MR

    ST LOUIS, MO 631666971

    Phone: (303) 465-0401

    Fax: (303) 438-1351

    Type: Mailing

  • PO BOX 2153 DEPT 20002

    BIRMINGHAM, AL 352870001

    Phone: (303) 465-0401

    Fax: (303) 438-1351

    Type: Mailing

  • 1 GOOD SAMARITAN WAY

    MOUNT VERNON, IL 628642402

    Phone: (618) 242-4600

    Type: Location

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: 2004-07-09

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
I20040709001422IDiagnostic RadiologyILTBD

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
77067Screening mammography519519$0
77063Screening 3d breast mammography517517$0
74176Ct scan of abdomen and pelvis without contrast439415$0
74177Ct scan of abdomen and pelvis with contrast321297$0
70450Ct scan head or brain without contrast171171$0
View full utilization report →

Insurance plans in this area (ZIP 63166)

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Provider's Procedures

JOHN RYAN WILLIS (MD) performs procedures in DIAGNOSTIC RADIOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYIL71010X-ray of chest, 1 view, front434363
DIAGNOSTIC RADIOLOGYIL71250CT scan chest8179
DIAGNOSTIC RADIOLOGYIL73630X-ray of foot, minimum of 3 views1111
DIAGNOSTIC RADIOLOGYIL74177CT scan of abdomen and pelvis with contrast300199
DIAGNOSTIC RADIOLOGYIL78815Nuclear medicine study with CT imaging skull base to mid-thigh123100

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: 2163733544View full group profile
NameSpecialtyState
Nuclear MedicineMO
-IL
Diagnostic RadiologyIL
-IL
Diagnostic RadiologyOH
Interventional Radiology, Interventional Radiology, Diagnostic Radiology, Diagnostic RadiologyAZ

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Frequently asked questions

How do I look up JOHN RYAN WILLIS (MD) by NPI?
Use NPI 1326095670 when you need to reference JOHN RYAN WILLIS (MD) in forms, claims, or directories.
Is JOHN RYAN WILLIS (MD) active in the national directory?
JOHN RYAN WILLIS (MD)'s public NPI profile is in an active state.
Does JOHN RYAN WILLIS (MD) list a primary specialty?
If you are matching referrals, note Diagnostic Radiology Physician for JOHN RYAN WILLIS (MD). Clinical services aligned with this taxonomy classification.
What location shows for JOHN RYAN WILLIS (MD)?
We surface St Louis, Missouri for JOHN RYAN WILLIS (MD) based on available NPPES addresses.
What if St Louis, Missouri seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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