Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083034920 Individual Practitioner Male Practitioner

Dr. Austin Glenn Willis , DO

Pediatrics • Albuquerque, NM

Professional Overview & Biography Verified Profile Summary

Dr. Austin Willis, DO is a registered healthcare professional specializing in Pediatrics in Albuquerque, NM. Practice services are available at 1100 CENTRAL AVE SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1100 Central Ave Se

Albuquerque, NM 871064930

Telephone 5058411063
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Albuquerque, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.3 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
253 Specialists

Practicing in Albuquerque, NM (471 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License NM A-2075-17

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License TX BP1-0059381

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
32103778 (NM)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

12 Associated Practitioners
Dr. Renee Triplet , DO

Pediatrics - Pediatric Critical Care Medicine

NPI 1023274131

Doctor of Osteopathic Medicine (D.O.)

NPI 1235834458

Doctor of Medicine (M.D.)

NPI 1275556375

Doctor of Medicine (M.D.)

NPI 1356435721

Doctor of Medicine (M.D.)

NPI 1366536740

Doctor of Medicine (M.D.)

Dr. John Finley , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1457445827

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Pediatrics (License #BP1-0059381 in TX)

NPI Profile Active September 08, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2017

Registered at 1100 CENTRAL AVE SE, ALBUQUERQUE, NM 871064930 (Tel: 5058411063)

📍
Updated Business Mailing Address September 08, 2017

Registered at PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 871256666 (Tel: (505) 923-6770)

👤
Provider Name / Credentials Updated September 08, 2017

Recorded as AUSTIN WILLIS, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2017

Pediatrics (License #A-2075-17 in NM)

NPI Profile Active April 18, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location April 18, 2014

Registered at 4900 MUELLER BLVD SUITE 3S.066C, UT SOUTHWESTERN AUSTIN - DELL CHILDRENS MEDICAL CENTER, AUSTIN, TX 78723 (Tel: 5123240165)

📍
Updated Business Mailing Address April 18, 2014

Registered at 4900 MUELLER BLVD SUITE 3S.066C, UT SOUTHWESTERN AUSTIN - DELL CHILDRENS MEDICAL CENTER, AUSTIN, TX 78723

👤
Provider Name / Credentials Updated April 18, 2014

Recorded as AUSTIN WILLIS, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2014

Pediatrics (License #BP1-0059381 in TX)

🟢
Initial NPI Registration & Enumeration April 18, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083034920
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 18, 2014
Last Update: July 21, 2022
Sole Proprietor: No

Mailing Address

Po Box 26666, Phs Provider Enrollment

Albuquerque, NM 871256666

Phone: 5059236770

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.