Andrew J Will MD PA

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

40619 Issued in MN

Legal business name

ANDREW J WILL MD PA

Practice address

683 Bielenberg Dr Ste 103
Woodbury, MN 55125-1711

Phone

(952) 841-2345

Fax

(952) 841-2346

NPI assigned

Feb 10, 2014

Organization subpart

No

Name

Andrew J. Will, MDNPI 1215997168

Title

Owner

Phone

(952) 841-2345

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

• Andrew J Will MD PA

  • Physical Medicine & Rehabilitation Physician
  • Edina, MN
  • NPI 1215003066

  O20041105000149

  Same enrollment
• Andrew J Will MD PA

  • Pain Clinic/Center
  • Burnsville, MN
  • NPI 1336655521

  O20041105000149

  Same enrollment
• Andrew J Will MD PA

  • Pain Clinic/Center
  • Maplewood, MN
  • NPI 1467157826

  O20041105000149

  Same enrollment
• Andrew J Will MD PA

  • Pain Clinic/Center
  • Chaska, MN
  • NPI 1669167920

  O20041105000149

  Same enrollment
• Andrew J Will MD PA

  • Physical Medicine & Rehabilitation Physician
  • Maple Grove, MN
  • NPI 1750797072

  O20041105000149

  Same enrollment

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

• Andrew J Will MD PA

  • Pain Clinic/Center
  • Burnsville, MN
  • NPI 1336655521
  NPD tax ID
• Andrew J Will MD PA

  • Pain Clinic/Center
  • Maplewood, MN
  • NPI 1467157826
  NPD tax ID
• Andrew J Will MD PA

  • Pain Clinic/Center
  • Chaska, MN
  • NPI 1669167920
  NPD tax ID
• Andrew J Will MD PA

  • Physical Medicine & Rehabilitation Physician
  • Maple Grove, MN
  • NPI 1750797072
  NPD tax ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew J. Will, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Edina, MN
  • NPI 1215997168

  Physical Medicine & Rehabilitation

  NPD Authorized official
• Cara Herrmann, CNP

  • Family Nurse Practitioner
  • Edina, MN
  • NPI 1982918967
  NPD
• Sally Kangas, CNP

  • Adult Health Nurse Practitioner
  • Edina, MN
  • NPI 1225466840
  NPD
• Anne Kokayeff, M.D.

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Woodbury, MN
  • NPI 1053516443
  NPD
• Katherine Christine Le-Banh, FNP-C

  • Nurse Practitioner
  • Edina, MN
  • NPI 1710537329
  NPD
• Kalisa Rurinda Ndikubwimana, DNP-CNP

  • Family Nurse Practitioner
  • Maplewood, MN
  • NPI 1427929124
  NPD
• Katelyn Parker-McGill, M.D., M.P.H.

  • Pain Medicine (Anesthesiology) Physician
  • Alexandria, MN
  • NPI 1013371053
  NPD
• Vincent Yaccarino, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Burnsville, MN
  • NPI 1851852008

  Physical Medicine & Rehabilitation

  NPD

Medicare fee-for-service enrollment

Enrolled in MN

Tax ID family

Andrew J Will MD PA (5 organizations share this tax ID)

Locations

Interoperability endpoints

• Direct secure messaging: kjerstin.durie.p1@direct.tcpain.nextgenshare.com
• Direct secure messaging: britta.carlson.p1@direct.tcpain.nextgenshare.com
• Direct secure messaging: anne.kokayeff@direct.tcpain.nextgenshare.com

• Twin Cities Pain Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 27, 2021.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369822000",
            "state": "MN"
        }
    ],
    "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"
        }
    ]
}

• Robert O Anderson, MD
• Sarah A Anderson, PA-C
• Susan L Andler, COTA/L
• Elena Andrade
• Andrew G Pierce Dba Blueprint Therapy Solutions
• Leshay Melanie Andrewin
• Margene Andrus, LPC, CDCII, CDCS
• Melinda Andryski
• Ositadinma C. Anene, M.D.
• Hannah Marie Angell

• All providers in Woodbury, MN
• Pain Clinic/Center in Minnesota

• 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.