NPIMap

Organization Active NPI

Andrew J Will MD PA

Doing business as Twin Cities Pain Clinic

  • Pain Clinic/Center
  • Woodbury, MN
National Provider Identifier
1699199737
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
40619 Issued in MN
Legal business name
ANDREW J WILL MD PA
Doing business as
Twin Cities Pain Clinic
Practice address
683 Bielenberg Dr Ste 103
Woodbury, MN 55125-1711
Phone
(952) 841-2345
Fax
(952) 841-2346
NPI assigned
Feb 10, 2014
Last updated
Dec 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Authorized official

Name
Andrew J. Will, MDNPI 1215997168
Title
Owner
Phone
(952) 841-2345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X
Pain Clinic/Center 261QP3300X 40619 MN Primary

Addresses

Primary practice location

683 Bielenberg Dr Ste 103
Woodbury, MN 55125-1711

Mailing address

7235 Ohms LN
Edina, MN 55439-2148
Phone (952) 841-2345

Other names 1

  • Twin Cities Pain Clinic Doing business as

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address tracey.baehlercnp.p1@direct.tcpain.nextgenshare.com Direct
Direct Messaging Address britta.carlson.p1@direct.tcpain.nextgenshare.com Direct
Direct Messaging Address Kjerstin.Durie.p1@direct.tcpain.nextgenshare.com Direct
Direct Messaging Address Anne.kokayeff@direct.tcpain.nextgenshare.com Direct
Direct Messaging Address tiffany.mcintyrecnp.p1@direct.tcpain.nextgenshare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000149 MN Part B Supplier - Clinic/Group Practice 9830152495 Receives reassigned benefits from 40 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Edina, MN; Woodbury, MN; Maplewood, MN; Maple Grove, MN; Chaska, MN; Burnsville, MN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Andrew J Will MD PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • Direct secure messaging: britta.carlson.p1@direct.tcpain.nextgenshare.com
  • Direct secure messaging: kjerstin.durie.p1@direct.tcpain.nextgenshare.com
  • Direct secure messaging: tiffany.mcintyrecnp.p1@direct.tcpain.nextgenshare.com
  • Direct secure messaging: tracey.baehlercnp.p1@direct.tcpain.nextgenshare.com

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1699199737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7235 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392148",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 BIELENBERG DR STE 103",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251711",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J WILL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "WILL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-841-2345",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MN",
            "license": "40619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracey.baehlercnp.p1@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "683 Bielenberg Dr Ste 103",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "britta.carlson.p1@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "683 Bielenberg Dr Ste 103",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kjerstin.Durie.p1@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "683 Bielenberg Dr Ste 103",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Anne.kokayeff@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "683 Bielenberg Dr Ste 103",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiffany.mcintyrecnp.p1@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "683 Bielenberg Dr Ste 103",
            "city": "Woodbury",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551251711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Twin Cities Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Twin Cities Pain Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; 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.