NPIMap

Individual provider Active NPI

Paul Daniel Williams, D.O.

  • Emergency Medicine Physician
  • Mankato, MN
National Provider Identifier
1316365281
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
61900 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
Mar 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 61900 MN
Emergency Medicine Physician 207P00000X 2016030784 MO
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 61900 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pwilliams90960@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170118002152 MO Practitioner - Emergency Medicine 8123320926 Reassigns benefits to 1 organization
I20170522002897 MN Practitioner - Emergency Medicine 8123320926 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City College of Medicine and Surgery, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians
University Health PhysiciansGroup PAC ID 1153235825, 344 clinicians

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1000

800 Medical Ctr Dr
Fairmont, MN 56031-4575
Phone (507) 238-8555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016030784MOMDEmergency Medicine Physician
61900MNMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-St James CurrentSince Mar 1, 2019 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 11, 2017 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Aug 13, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-St James Current Accepting new patients
University Health Physicians Emergency Medicine CurrentSince Dec 17, 2018 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jun 11, 2017 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 13, 2022 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Aug 13, 2022 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

4407 E 50th Ter
Kansas City, MO 64130
Phone (816) 924-1201

2310 Holmes St
Ste 800
Kansas City, MO 64108
Phone (816) 218-2500

2301 Holmes St
Kansas City, MO 64108

Interoperability endpoints

  • Direct secure messaging: paul.williams@direct.tmcmed.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 8

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": "1395964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1316365281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "PAUL",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-28",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MN",
            "license": "61900",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2016030784",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "61900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwilliams90960@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.