Individual provider Active NPI

Kasey Christine Willson, PA-C, MPH

  • Physician Assistant
  • Bloomington, MN
National Provider Identifier
1609384544
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13740 Issued in MN
Practice address
4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone
(320) 221-3466
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55277 CA
Physician Assistant 363A00000X 13740 MN Primary

Addresses

Primary practice location

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435

Mailing address

4300 Marketpointe Dr Ste 100
Bloomington, MN 55435-5435
Phone (952) 835-9880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwillson566401@excellian.direct.allina.com Direct ALLINA HEALTH SYSTEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211202002266 MN Practitioner - Physician Assistant 9537421995 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Advocate Urgent Care PLLCGroup PAC ID 4880043082, 18 clinicians
MN UC Providers LTDGroup PAC ID 8729461421, 14 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

12643 Fremont Ave
Zimmerman, MN 55398-9755
Phone (218) 838-9355

13540 Grove Dr N
Maple Grove, MN 55311-4400
Phone (952) 931-1276

415 17TH Ave N
Suite 100
Hopkins, MN 55343-7226
Phone (952) 931-1276

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

8675 Valley Creek Rd
Woodbury, MN 55125-2337
Phone (651) 241-3000

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55277CAMDPharmacist
13740MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Francis Regional Medical Center CurrentSince Aug 1, 2023 Accepting new patients
MN UC Providers LTD CurrentSince Aug 28, 2022 Accepting new patients
County of Meeker CurrentSince Mar 1, 2023 Accepting new patients
County of Meeker CurrentSince Jan 13, 2026 Accepting new patients
Allina Health System CurrentSince Feb 1, 2023 Accepting new patients
County of Meeker CurrentSince Mar 1, 2023 Accepting new patients
Allina Health System CurrentSince Feb 1, 2023 Accepting new patients
St Francis Regional Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

415 17th Ave N
Ste 100
Hopkins, MN 55343
Phone (952) 931-1276

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

13540 Grove Dr N
Maple Grove, MN 55311
Phone (952) 931-1276

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

5565 Blaine Ave
South St Paul, MN 55076
Phone (651) 241-9400

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

Interoperability endpoints

  • Direct secure messaging: kwillson566401@excellian.direct.allina.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1609384544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "952-835-9880",
            "fax_number": "952-857-1554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARKETPOINTE DR STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355435",
            "telephone_number": "320-221-3466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLSON",
        "first_name": "KASEY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55277",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwillson566401@excellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "ALLINA HEALTH SYSTEM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "8675 Valley Creek Rd",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551252337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.