Kelly M. Williams, M.D.
NPI 1679718415ActiveIndividual· Dermatology· Burnsville, MN
Dermatology (M.D.) with Lakes Dermatology PA, practicing in Burnsville, Minnesota. Medicare paid $509.00 for services to 26 patients in 2024.
Overview
| NPI | 1679718415 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Dec 9, 2008 |
| Last updated in NPPES | Oct 30, 2025 |
| Certified by provider | Oct 30, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 79617 | MN |
| Internal Medicine | 207R00000X | 57.015265 | OH |
| Dermatology | 207N00000X | DR0052504 | CO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Dermatology (CO); Practitioner - Dermatology (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 26 |
|---|---|
| Services billed | 52 across 6 procedure codes |
| Paid by Medicare | $509.00 |
Education and affiliations
| Graduation year | 2008 |
|---|---|
| Medicare specialty | Dermatology |
Medical group
- Lakes Dermatology PAMinnetonka, MN · 8 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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