NPIMap

Individual provider Active NPI

David Allen Willey, MD

  • Family Medicine Physician
  • Chaska, MN
National Provider Identifier
1043207681
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23682 Issued in MN
Practice address
1200 Chaska Creek Way
Suite 200
Chaska, MN 55318-2152
Phone
(952) 448-3303
Fax
(952) 448-4409
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23682 MN Primary

Addresses

Primary practice location

1200 Chaska Creek Way
Suite 200
Chaska, MN 55318-2152

Mailing address

1200 Chaska Creek Way
Suite 200
Chaska, MN 55318
Phone (952) 856-1046

Other identifiers 1

IdentifierTypeStateIssuer
174568900MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050426000596 MN Practitioner - Family Practice 3375582786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians
Key CorporationGroup PAC ID 9032009238, 53 clinicians

Practice addresses (Care Compare)

1200 Chaska Creek Way
Suite 200
Chaska, MN 55318-2749
Phone (952) 927-2960

1394 Jackson St
Suite 201
Saint Paul, MN 55117-4630
Phone (612) 315-5866

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

7701 York Ave S
Suite 180
Minneapolis, MN 55435-5845
Phone (952) 927-5316

Hospital & facility affiliations

  • Allina Health Home Health Home health agency, Minneapolis, MN, CCN 248091
  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056
  • St Francis Regional Medical Center Hospital, Shakopee, MN, CCN 240104

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jan 1, 2019 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

1200 Chaska Creek Way
Ste 200
Chaska, MN 55318
Phone (952) 856-1046

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

1455 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 403-2200

204 Lewis Ave S
Ste 201
Watertown, MN 55388
Phone (952) 442-2137

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1043207681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHASKA CREEK WAY",
            "address_2": "SUITE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "55318",
            "telephone_number": "952-856-1046",
            "fax_number": "952-856-1049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHASKA CREEK WAY",
            "address_2": "SUITE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182152",
            "telephone_number": "952-448-3303",
            "fax_number": "952-448-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLEY",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "23682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174568900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.