Individual provider Active NPI

Michael Willig, MD

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1639253156
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25546 Issued in CO
Practice address
3464 S Willow St
Suite 853
Denver, CO 80231-4531
Phone
(303) 755-2900
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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 25546 CO Primary

Addresses

Primary practice location

3464 S Willow St
Suite 853
Denver, CO 80231-4531

Mailing address

1421 S Potomac St Ste 210
Suite 240
Aurora, CO 80012-4512
Phone (303) 923-3831

Other identifiers 2

IdentifierTypeStateIssuer
WI96971OtherCOBLUE SHIELD
01255462MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115001058 CO Practitioner - Family Practice 5597729004 Practice locations: Aurora, CO

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25546COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Affiliates Past Accepting new patients

Organizations & group practices 1

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1639253156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 S POTOMAC ST STE 210",
            "address_2": "SUITE 240",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124512",
            "telephone_number": "303-923-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 S WILLOW ST",
            "address_2": "SUITE 853",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802314531",
            "telephone_number": "303-755-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIG",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "25546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "WI96971",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01255462",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.