Active NPI
Stephanie Willet, M.D.
- Anesthesiology Physician
- Minot, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 14725
- Practice address
- 1 Burdick Expy W
Minot, ND 58701-4406 - Phone
- (701) 857-5124
- NPI assigned
- Apr 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 14725 | ND | Primary |
Addresses
Primary practice location
1 Burdick Expy W
Minot, ND 58701-4406
Mailing address
11645 Vixens Path
Ellicott City, MD 21042-1541
Phone (410) 404-2881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of South Florida College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1650 Cowles St
Fairbanks, AK 99701-5907
Phone (907) 459-3500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.86 of 100
- Quality
- 94.88
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14725 | ND | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Healthcare Specialists PC | Anesthesiology | Current | Accepting new patients |
| Tanana Valley Clinic LLC | Current | Accepting new patients | |
| Tanana Valley Clinic LLC | Current | Accepting new patients |
Locations
1650 Cowles St
Fairbanks, AK 99701
Phone (907) 452-8181
1001 Noble St
Fairbanks, AK 99701
Phone (907) 276-2806
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Fairbanks, AK
- NPI 1922559558
-
- Anesthesiology Physician
- Hackensack, NJ
- NPI 1174585780
-
- Multi-Specialty Clinic/Center
- Fairbanks, AK
- NPI 1073081485
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fairbanks, AK
- NPI 1720537178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1023375292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11645 VIXENS PATH",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210421541",
"telephone_number": "410-404-2881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BURDICK EXPY W",
"city": "MINOT",
"state": "ND",
"postal_code": "587014406",
"telephone_number": "701-857-5124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLET",
"first_name": "STEPHANIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "ND",
"license": "14725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.