NPIMap

Individual provider Active NPI

William Warren Sheaffer, M.D.

  • Vascular Surgery Physician
  • Duluth, MN
National Provider Identifier
1750768388
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
71045 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 52930 AZ
Vascular Surgery Physician 2086S0129X 52930 AZ
Vascular Surgery Physician 2086S0129X 71045 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wsheaffer389880@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000829 MN Practitioner - Vascular Surgery 5991012569 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Sanford School of Medicine of University of South Dakota, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Essentia Health Virginia Hospital, Virginia, MN, CCN 240084
  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075
  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • St Marys Hospital Superior Hospital, Superior, WI, CCN 521329

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)31
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52930AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Medical Center Current Accepting new patients
St Marys Medical Center CurrentSince Oct 1, 2024 Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 15, 2022 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
St Joseph'S Medical Center CurrentSince Jan 22, 2024 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 15, 2022 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Jan 22, 2024 Accepting new patients
St. Joseph'S Medical Center CurrentSince Jan 22, 2024 Accepting new patients
Brainerd Medical Center Inc CurrentSince Jan 22, 2024 Accepting new patients
St. Mary'S Medical Center CurrentSince Oct 1, 2024 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
St. Joseph'S Medical Center Past Accepting new patients

Locations

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

1542 Golf Course Rd
Ste 204
Grand Rapids, MN 55744
Phone (218) 322-4900

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

Interoperability endpoints

  • Direct secure messaging: wsheaffer389880@ehrdirect.mayoclinicmsg.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 and National Provider Directory roles.

View all 13

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1750768388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAFFER",
        "first_name": "WILLIAM",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-04",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "52930",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AZ",
            "license": "52930",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MN",
            "license": "71045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wsheaffer389880@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.