Derek S Olson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

65111 Issued in OR

Practice address

1340 E 47TH St
Chicago, IL 60653-4508

Phone

(773) 496-5147

Fax

(872) 215-9417

NPI assigned

Apr 20, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, CA, OR3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Proactive LLCGroup PAC ID 7315218708, 53 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.49 of 100Reported as group

Quality

90

Improvement activities

40

Cost

73.3

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derek.olson.p7@direct.athleticoltd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Proactive LLC

  • Physical Therapy Clinic/Center
  • Oregon City, OR
  • NPI 1396273199

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Athletic and Therapeutic Institute of Naperville LLC

  • Physical Therapist
  • Aurora, IL
  • NPI 1023129681
  Medicare reassignment NPD
• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  Medicare reassignment NPD
• H.D.P.R.G., Inc

  • Speech-Language Pathologist
  • Twentynine Palms, CA
  • NPI 1295886067

  Physical Therapist

  Medicare reassignment NPD
• Athletic and Therapeutic Institute of Naperville, LLC

  • Durable Medical Equipment & Medical Supplies
  • Hazel Crest, IL
  • NPI 1043952641
  NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Omnis Omnia Inc.

  • Orthopedic Physical Therapist
  • Redmond, OR
  • NPI 1013949239
  NPD (past)
• Physical Therapy at Dawn Inc

  • Orthopedic Physical Therapist
  • Albuquerque, NM
  • NPI 1114282340
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1003497116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 E 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606534508",
            "telephone_number": "773-496-5147",
            "fax_number": "872-215-9417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Central Ave SE Ste D",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871024650",
            "country_code": "US",
            "telephone_number": "505-242-2294",
            "fax_number": "505-242-2917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1307 NE 102nd Ave Ste T-1",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203980",
            "country_code": "US",
            "telephone_number": "971-270-0913",
            "fax_number": "971-270-0914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 S State St",
            "address_purpose": "LOCATION",
            "city": "Marengo",
            "state": "IL",
            "postal_code": "601523532",
            "country_code": "US",
            "telephone_number": "815-568-4550",
            "fax_number": "815-568-5071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "DEREK",
        "middle_name": "S",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302169",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ambria Olson
• Audrey Olson, CF-SLP
• Courtney Olson
• Daniel Olson, M.D.
• Daniel Lee Olson, APRN, CRNA
• Elsa Olson, MD
• Eric Alfredo Olson
• Eric Robert Olson, OTR/L
• Erik Olson, NP
• Gary R. Olson, DDS

• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.