NPIMap

Individual provider Active NPI

Mary Alivia Tolsma, PA

  • Physician Assistant
  • Eagan, MN
National Provider Identifier
1023425402
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11616 Issued in MN
Practice address
1885 Plaza Dr
Eagan, MN 55122-2979
Phone
(952) 993-4001
NPI assigned
Jul 17, 2014
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11616 MN Primary

Addresses

Primary practice location

1885 Plaza Dr
Eagan, MN 55122-2979

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

671 Vandalia Street
Saint Paul, MN 55114
Phone (651) 698-2406

Other practice location 2

1880 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-1800

Other practice location 3

451 Dunlap St N
Saint Paul, MN 55104-4619
Phone (651) 967-7201

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mtolsma318681@excellian.direct.allina.com Direct

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
I20150214000036 MN Practitioner - Physician Assistant 3577888544 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Park Nicollet Clinic CurrentSince Nov 4, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Nov 4, 2024 Accepting new patients
Allina Health System CurrentSince Jun 3, 2019 Accepting new patients
Group Health, Inc. CurrentSince Nov 4, 2024 Accepting new patients
Group Health, Inc. CurrentSince Nov 4, 2024 Accepting new patients
Allina Health System CurrentSince Jun 3, 2019 Accepting new patients
Westfields Hospital, Inc. Past Accepting new patients
Amery Regional Medical Center, Inc. Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

1880 N Frontage Rd
Hastings, MN 55033
Phone (651) 438-1800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1885 Plaza Dr
Saint Paul, MN 55122
Phone (952) 993-4001

451 Dunlap St N
Saint Paul, MN 55104
Phone (651) 647-2100

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0308

Interoperability endpoints

  • Direct secure messaging: mtolsma318681@excellian.direct.allina.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 6

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": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1023425402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 PLAZA DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222979",
            "telephone_number": "952-993-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Vandalia Street",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "55114",
            "country_code": "US",
            "telephone_number": "651-698-2406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1880 N Frontage Rd",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MN",
            "postal_code": "55033",
            "country_code": "US",
            "telephone_number": "651-438-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "451 Dunlap St N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551044619",
            "country_code": "US",
            "telephone_number": "651-967-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLSMA",
        "first_name": "MARY",
        "middle_name": "ALIVIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtolsma318681@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1880 N Frontage Rd",
            "city": "Hastings",
            "state": "MN",
            "country_code": "US",
            "postal_code": "55033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.