Active NPI
Willard James Michalski, M.D.
- Otolaryngology Physician
- Mankato, MN
National Provider Identifier
1922087220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 22210
- Practice address
- 112 Beech Street
Mankato, MN 56001 - Phone
- (507) 625-1589
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 22210 | MN | Primary |
Addresses
Primary practice location
112 Beech Street
Mankato, MN 56001
Mailing address
112 Beech Street
Mankato, MN 56001
Phone (507) 625-1589
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040008067 | Other | RR MEDICARE | |
| 115547 | Other | MN | UCARE |
| 1001399 | Other | MN | MEDICA |
| 555882400 | Medicaid | MN | |
| 767278 | Other | MN | AMERICAS PPO |
| HP25854 | Other | MN | HEALTH PARTNERS |
| 41461MI | Other | MN | BCBS |
| 928655 | Other | IA | MEDICAID |
| NA2951023845 | Other | MN | PREFERRED ONE |
| 410849339 56001 C047 | Other | CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22210 | MN | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1922087220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "112 BEECH STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "56001",
"telephone_number": "507-625-1589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 BEECH STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "56001",
"telephone_number": "507-625-1589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHALSKI",
"first_name": "WILLARD",
"middle_name": "JAMES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MN",
"license": "22210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "040008067",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "115547",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1001399",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "555882400",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "767278",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25854",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "41461MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "928655",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA2951023845",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "410849339 56001 C047",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.