Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Rudolph Willis, MD

Individual provider Specialist · NPI 1104887819

Dr. Rudolph Willis, MD is a Family Practice in Irvington, New Jersey. Graduated from Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc) in 1982, 44 years ago. Practices with Meritus Medical Center Inc, a 746-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
44
Trained at
Rutgers R W Johnson Medical School (CAM/NEW Bruns/Pisc)
Licensed in
NJ
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12 Krotik Pl Irvington Emergent Care And Rehabilitation Center Inc
Irvington, NJ 07111-1708
Phone: (973) 373-3000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 25MA04275000 (NJ)
Specialist Taxonomy 174400000X · Licence MA42750 (NJ)

Record details

NPI number1104887819
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2006
Last updated in NPPESMarch 10, 2026
Certification dateMarch 10, 2026
Mailing address12 Krotik Pl, Irvington Emergent Care And Rehabilitation Center Inc., Irvington, NJ 07111-1708

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolRUTGERS R W JOHNSON MEDICAL SCHOOL (CAM/NEW BRUNS/PISC)
Graduated 1982 (44 years in practice)
Group practice Meritus Medical Center Inc — 746 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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