NPIMap

Individual provider Active NPI

Olaf JS Samuelson, DO

  • Internal Medicine Physician
  • Austin, MN
National Provider Identifier
1013535988
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75926 Issued in MN
Practice address
1000 1St Dr NW
Austin, MN 55912-2941
Phone
(507) 433-7351
NPI assigned
Jul 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2020018217 MO
Internal Medicine Physician 207R00000X 75926 MN Primary

Addresses

Primary practice location

1000 1St Dr NW
Austin, MN 55912-2941

Mailing address

1000 1St Dr NW
Austin, MN 55912-2941
Phone (507) 433-7351

Other practice location 1

315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone (660) 785-1400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address osamuelson2077162@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001217 MN Practitioner - Internal Medicine 4981056512 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, shared by 9 NPIs, 550 clinicians
Mayo Clinic Health System-Lake CityGroup PAC ID 1951213487, shared by 4 NPIs, 70 clinicians

Practice addresses (Care Compare)

1000 1St Dr NW
Austin, MN 55912-2941
Phone (507) 433-7351

500 W Grant St
Lake City, MN 55041-1143
Phone (651) 345-3321

Hospital & facility affiliations

  • Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043
  • Mayo Clinic Health System in Red Wing Hospital, Red Wing, MN, CCN 240018
  • Mayo Clinic Health System - Lake City Hospital, Lake City, MN, CCN 241338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2020018217MOMDFamily Medicine Physician
75926MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 5, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 5, 2024 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jan 5, 2024 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: osamuelson2077162@ehrdirect.mayoclinicmsg.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1013535988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 1ST DR NW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559122941",
            "telephone_number": "507-433-7351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 S Osteopathy Ave",
            "address_purpose": "LOCATION",
            "city": "Kirksville",
            "state": "MO",
            "postal_code": "635016401",
            "country_code": "US",
            "telephone_number": "660-785-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELSON",
        "first_name": "OLAF",
        "middle_name": "JS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020018217",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "75926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "osamuelson2077162@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1000 1st Dr NW",
            "city": "Austin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559122941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, MN

Sources for this page

Verify at the official NPI Registry.