Dr David John Willis, MD in St Louis Park, MN - Medicare Colorectal Surgery (proctology)

Dr David John Willis, MD is a medicare enrolled "Colon & Rectal Surgery" physician in St Louis Park, Minnesota. He went to New York University School Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Colorectal Surgery (proctology). He is a member of the group practice Park Nicollet Clinic and his current practice location is 3931 Louisiana Ave S, Meadowbrook Bldg Suite W-200, St Louis Park, Minnesota. You can reach out to his office (for appointments etc.) via phone at (952) 993-3466.

Dr David John Willis is licensed to practice in Minnesota (license number 48801) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760537534.

Contact Information

	Dr David John Willis, MD
	3931 Louisiana Ave S, Meadowbrook Bldg Suite W-200, St Louis Park, MN 55426-4375
	(952) 993-3466
	(952) 993-3653

Map and Direction

Physician's Profile

Full Name	Dr David John Willis
Gender	Male
Speciality	Colorectal Surgery (proctology)
Experience	25 Years
Location	3931 Louisiana Ave S, St Louis Park, Minnesota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr David John Willis attended and graduated from New York University School Of Medicine in 1999

NPI Data:

NPI Number: 1760537534
Provider Enumeration Date: 01/24/2007
Last Update Date: 07/02/2021

Medicare PECOS Information:

PECOS PAC ID: 7618078593
Enrollment ID: I20070723000078

Medical Identifiers

Medical identifiers for Dr David John Willis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1760537534	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	48801 (Minnesota)	Secondary
208C00000X	Colon & Rectal Surgery	48801 (Minnesota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Park Nicollet Methodist Hospital	Saint louis park, MN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Park Nicollet Clinic	7911819438	1530

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr David John Willis allows following entities to bill medicare on his behalf.

Entity Name	Park Nicollet Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David John Willis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr David John Willis, MD 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () -	Dr David John Willis, MD 3931 Louisiana Ave S, Meadowbrook Bldg Suite W-200, St Louis Park, MN 55426-4375 Ph: (952) 993-3466

Dr David John Willis, MD - Medicare Colorectal Surgery (proctology) in St Louis Park, MN