DR. RUDOLPH WILLIS (MD) – Family Medicine Physician, NPI 1104887819
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,515 FAMILY PRACTICE in NJ
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Provider Addresses for DR. RUDOLPH WILLIS (MD)
12, Krotik Place, Irvington, Essex County, New Jersey, 07111, United States
IRVINGTON EMERGENT CARE AND REHABILITATION CENTER INC.
IRVINGTON, NJ 071111708
Phone: (973) 373-3000
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 64 Open Payments records for all available years, with a total value of $1,890.
Total Amount is formed as General ($1,890) + Research ($0) + Ownership ($0) = $1,890.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($544).
Total Amount
$1,890
General + Research + Ownership
Payments
64
Total payment records
General Amount
$1,890
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $544 |
| Novo Nordisk Inc | $366 |
| SANOFI-AVENTIS U.S. LLC | $162 |
| Kowa Pharmaceuticals America, Inc. | $162 |
| GlaxoSmithKline, LLC. | $125 |
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: 2007-07-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070730000535 | I | Family Practice | NJ | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 102 | 52 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 30 | 25 | $0 |
Insurance plans in this area (ZIP 07111)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, Geriatric Medicine | NJ | |
| Internal Medicine | NY | |
| - | NJ | |
| Cardiovascular Disease (Cardiology), Internal Medicine | NJ | |
| Nurse Practitioner | NJ | |
| - | NJ | |
| - | NY | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | NJ | |
| Internal Medicine | NJ | |
| - | NJ |
Reviews
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