DR. JACQUELINE KAY WILLE (MD) – Family Medicine Physician, NPI 1114776853

DR. JACQUELINE KAY WILLE (MD) is a healthcare provider. based in Duluth, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 80900 (MN). The NPI Number for DR. JACQUELINE KAY WILLE (MD) is 1114776853

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACQUELINE KAY WILLE (MD)
NPI
1114776853
Phone
(218) 723-1112
Address
330 N 8TH AVE E
Enumeration Date
15 May 2024
Last Update Date
9 January 2026

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
2187231112
Graduation Year
2024 (2 years ago)
PAC ID
7214471432
Group Practice PAC ID
4385545953
Professional Enrollment ID
I20260127003053
Address ID
MN558052024DU330XXEXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

3,076 FAMILY PRACTICE in MN

Provider Addresses for DR. JACQUELINE KAY WILLE (MD)

  • 330 N 8TH AVE E

    DULUTH, MN 558052024

    Phone: (218) 723-1112

    Mailing address matches the actual address.

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: 2026-01-27

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
I20260127003053IFamily PracticeMNTBD

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 55805)

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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: 4385545953View full group profile
NameSpecialtyState
-MN
Family PracticeMN
Family PracticeWI
Family PracticeMN
Family PracticeMN
Family PracticeMN
Family PracticeMN
Mental Health CounselorMN
Family PracticeMN
Family PracticeMN

Reviews

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Frequently asked questions

Is DR. JACQUELINE KAY WILLE (MD) listed with a National Provider Identifier?
Yes — DR. JACQUELINE KAY WILLE (MD) has NPI 1114776853 on file in the registry.
Is DR. JACQUELINE KAY WILLE (MD) shown as active in public data?
Registry records indicate DR. JACQUELINE KAY WILLE (MD) maintains an active NPI.
What area of care is associated with DR. JACQUELINE KAY WILLE (MD)?
DR. JACQUELINE KAY WILLE (MD)'s record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. JACQUELINE KAY WILLE (MD) associated with Duluth?
Public fields place DR. JACQUELINE KAY WILLE (MD) around Duluth, Minnesota. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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