Individual provider Active NPI

William J Mullin, MD

  • Diagnostic Radiology Physician
  • St Louis Park, MN
National Provider Identifier
1891762688
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36643 Issued in MN
Practice address
5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone
(952) 541-1840
Fax
(952) 513-6880
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 36643 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416

Mailing address

PO Box 1450
NW 6035
Minneapolis, MN 55485-6035
Phone (952) 542-8553

Other identifiers 1

IdentifierTypeStateIssuer
091527100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050519000717 MN Practitioner - Diagnostic Radiology 9133015381 Reassigns benefits to 2 organizations
I20220705000097 HI Practitioner - Diagnostic Radiology 9133015381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Un of California, Irvine, College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

1790 Beam Ave
Maplewood, MN 55109-1162
Phone (651) 294-4639

2270 Ford Pkwy
Suite 202
Saint Paul, MN 55116-3412
Phone (651) 455-5500

2305 108TH LN NE
Blaine, MN 55449-5222
Phone (763) 278-4429

3809 Tantalus Dr
Honolulu, HI 96822-5022
Phone (952) 738-4441

3833 Coon Rapids Blvd NW
Suite 120
Coon Rapids, MN 55433-2599
Phone (763) 433-2000

5775 Wayzata Blvd
St Louis Park, MN 55416-1271

5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840

6025 Lake Rd
Suite 130
Woodbury, MN 55125-1713
Phone (651) 735-1840

675 E Nicollet Blvd
Suite 150
Burnsville, MN 55337-6742
Phone (952) 898-6627

9630 Grove Cir N
Suite 100
Maple Grove, MN 55369-3477
Phone (763) 416-9916

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Jul 29, 2015 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Jul 5, 1993 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince Jul 5, 1993 Accepting new patients
Cdi Twin Cities ASC LLC Current Accepting new patients
Diagnostic Centers of America LLP Diagnostic Radiology PastSince Apr 15, 2024 Accepting new patients
Medical Scanning Consultants, P.a. Diagnostic Radiology Past Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology PastSince Aug 15, 2021 Accepting new patients

Locations

1781 Park Center Dr
Ste 110
Orlando, FL 32835
Phone (407) 253-7190

1000 W Broadway St
Ste 140
Oviedo, FL 32765
Phone (407) 359-6001

964 S Orlando Ave
Winter Park, FL 32789
Phone (407) 628-5051

8607 E US Highway 36
Ste 200
Avon, IN 46123
Phone (317) 569-5855

11900 Pennsylvania St
Ste 100
Carmel, IN 46032

11900 Pennsylvania St
Ste 202
Carmel, IN 46032
Phone (317) 569-5767

10206 Lantern Rd
Fishers, IN 46037
Phone (317) 598-1133

521 E County Line Rd
Ste D
Greenwood, IN 46143
Phone (317) 882-9422

1250 N Post Rd
Ste A
Indianapolis, IN 46219
Phone (317) 899-7980

7151 Marsh Rd
#100
Indianapolis, IN 46278
Phone (317) 580-5880

3738 Landmark Dr
Ste D
Lafayette, IN 47905
Phone (765) 449-7984

13436 Tegler Dr
Ste 400
Noblesville, IN 46060
Phone (317) 569-5777

4313 S 7th St
Terre Haute, IN 47802
Phone (812) 234-0555

9630 Grove Cir N
Ste 100
Maple Grove, MN 55369
Phone (763) 416-9916

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338

5775 Wayzata Blvd
Ste 400
St Louis Park, MN 55416
Phone (952) 525-6338

33801 1st Way S
Ste 101
Federal Way, WA 98003
Phone (253) 942-7226

7308 Bridgeport Way W
Ste 101
Lakewood, WA 98499
Phone (253) 682-1666

W129N7055 Northfield Dr
Ste 101
Menomonee Falls, WI 53051
Phone (262) 253-5055

2315 E Moreland Blvd
Ste 1500
Waukesha, WI 53186
Phone (262) 646-5199

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

2445 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 774-7226

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1891762688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450",
            "address_2": "NW 6035",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD",
            "address_2": "STE 190",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-541-1840",
            "fax_number": "952-513-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "36643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091527100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.