NPIMap

Organization Active NPI

Andrew J Will MD PA

Doing business as Twin Cities Pain Clinic

  • Physical Medicine & Rehabilitation Physician
  • Maple Grove, MN
National Provider Identifier
1750797072
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ANDREW J WILL MD PA
Doing business as
Twin Cities Pain Clinic
Practice address
12000 Elm Creek Blvd N Ste 300
Maple Grove, MN 55369-7075
Phone
(952) 841-2345
Fax
(952) 841-2346
NPI assigned
Jul 8, 2014
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

12000 Elm Creek Blvd N Ste 300
Maple Grove, MN 55369-7075

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
369822000MedicaidMN

Other names 1

  • Twin Cities Pain Clinic Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aimee.heinen@direct.tcpain.nextgenshare.com Direct
Direct Messaging Address austin.heneman.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.

Locations

7270 Forestview Ln N
Ste 100
Maple Grove, MN 55369

7235 Ohms Ln
Minneapolis, MN 55439
Phone (952) 204-3502

Interoperability endpoints

  • Direct secure messaging: aimee.heinen@direct.tcpain.nextgenshare.com
  • Direct secure messaging: austin.heneman.p1@direct.tcpain.nextgenshare.com

Practitioners & affiliated clinicians

Practitioners 7

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": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1750797072",
    "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": "12000 ELM CREEK BLVD N STE 300",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697075",
            "telephone_number": "952-841-2345",
            "fax_number": "952-841-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW J WILL MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "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": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369822000",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aimee.heinen@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7270 Forestview Ln N Ste 100",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553695555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "austin.heneman.p1@direct.tcpain.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7270 Forestview Ln N Ste 100",
            "city": "Maple Grove",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553695555",
            "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 Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.