CASEY WILLMAN (DO) – Internal Medicine Physician, NPI 1619554896

CASEY WILLMAN (DO) is a healthcare provider. based in Idaho falls, Idaho. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 218170 (AK). The NPI Number for CASEY WILLMAN (DO) is 1619554896

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
CASEY WILLMAN (DO)
NPI
1619554896
Phone
(208) 529-6111
Address
3100 CHANNING WAY
Enumeration Date
25 March 2021
Last Update Date
26 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072761131
Graduation Year
2021 (5 years ago)
PAC ID
6406256155
Group Practice PAC ID
5395100598
Professional Enrollment ID
I20240812002038
Address ID
AK995082932AN2801XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

560 INTERNAL MEDICINE in ID

Provider Addresses for CASEY WILLMAN (DO)

  • 3100 CHANNING WAY

    IDAHO FALLS, ID 834047533

    Phone: (208) 529-6111

    Type: Location

  • 3100 Channing Way

    Idaho Falls, ID 834047533

    Phone: (208) 529-6111

    Type: Location

  • 2801 DEBARR RD

    ANCHORAGE, AK 995082932

    Phone: (907) 276-1131

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240812002038IInternal MedicineAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83404)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395100598View full group profile
NameSpecialtyState
Internal MedicineMT
Internal MedicineDC
Internal MedicineFL
Emergency MedicineOR
Family PracticeCA
Internal MedicineMI
Internal MedicineTX
Physician AssistantOR
Internal Medicine, HospitalistNY
Physician AssistantOR

Reviews

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Frequently asked questions

What is CASEY WILLMAN (DO)'s NPI number?
CASEY WILLMAN (DO)'s NPI is 1619554896 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to CASEY WILLMAN (DO)?
You should see CASEY WILLMAN (DO) as active in CMS-hosted NPPES data.
How would a patient describe CASEY WILLMAN (DO)'s focus?
For CASEY WILLMAN (DO), the primary taxonomy reads as Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is CASEY WILLMAN (DO) associated with Idaho Falls?
Public fields place CASEY WILLMAN (DO) around Idaho Falls, Idaho. Always confirm the exact site before visiting.
Does CASEY WILLMAN (DO) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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