NPIMap

Individual provider Active NPI

Michelle Marie Dolan, M.D.

  • Clinical Molecular Genetics Physician
  • Minneapolis, MN
National Provider Identifier
1033140223
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Molecular Genetics PhysicianTaxonomy code 207SG0203X
License
42857 Issued in MN
Practice address
420 Delaware Street SE, 760 Mayo Memorial Building
University of Minnesota Physicians
Minneapolis, MN 55455
Phone
(612) 626-0622
Fax
(612) 626-2696
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cytogenetics Physician 207SC0300X 42857 MN
Clinical Molecular Genetics Physician 207SG0203X 42857 MN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 42857 MN

Addresses

Primary practice location

420 Delaware Street SE, 760 Mayo Memorial Building
University of Minnesota Physicians
Minneapolis, MN 55455

Mailing address

420 Delaware Street SE
MMC 669 University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 626-0622

Other identifiers 7

IdentifierTypeStateIssuer
160147400MedicaidMN
HP41076OtherMNHEALTHPARTNERS
140155OtherMNUCARE
009A5DOOtherMNBCBS
1131521OtherMNARAZ
1025646OtherMNPREFERRED ONE
11-00106OtherMNMEDICA CHOICE & PRIMARY

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
I20100824000930 MN Practitioner - Pathology 2163546441 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42857MNMDClinical Cytogenetics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 16, 2023 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Feb 22, 2016 Accepting new patients
Fairview Health Services CurrentSince Nov 1, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Health Services CurrentSince Nov 1, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Mar 1, 2002 Accepting new patients
Fairview Clinics CurrentSince Nov 1, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Feb 22, 2016 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Physicians CurrentSince Mar 1, 2002 Accepting new patients
Fairview Clinics CurrentSince Nov 1, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

420 Delaware St SE
#760
Minneapolis, MN 55455
Phone (612) 626-0622

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

420 Delaware St SE
#669
Minneapolis, MN 55455

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

Interoperability endpoints

  • Direct secure messaging: mdolan147959@fairview.direct-ci.com

Organizations & group practices 17

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 17

Hospital & facility affiliations 9

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336694400000",
    "number": "1033140223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "MMC 669 UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-0622",
            "fax_number": "612-626-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE, 760 MAYO MEMORIAL BUILDING",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-0622",
            "fax_number": "612-626-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2012-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "MN",
            "license": "42857",
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "MN",
            "license": "42857",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MN",
            "license": "42857",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160147400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP41076",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140155",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "009A5DO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "1131521",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1025646",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE & PRIMARY",
            "identifier": "11-00106",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.