Individual provider Active NPI

Christopher John Tolan, MD

  • Facial Plastic Surgery Physician
  • Woodbury, MN
National Provider Identifier
1043256357
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
36117 Issued in MN
Practice address
217 Radio Dr
Woodbury, MN 55125-5805
Phone
(651) 702-0750
Fax
(651) 645-6166
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 36117 MN
Facial Plastic Surgery Physician 207YS0123X 40701-20 WI
Surgery Physician 208600000X 40701-20 WI
Facial Plastic Surgery Physician 207YS0123X 36117 MN Primary

Addresses

Primary practice location

217 Radio Dr
Woodbury, MN 55125-5805

Mailing address

215 Radio Dr Ste 202
Woodbury, MN 55125-5822
Phone (651) 702-0750

Other practice location 1

2651 Hillcrest Dr Ste 302
Hudson, WI 54016-9919
Phone (651) 702-0750

Other practice location 2

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Other practice location 3

3460 Promenade Ave
Eagan, MN 55123-4404
Phone (651) 702-0750

Other practice location 4

11020 161st St W
Lakeville, MN 55044-6507
Phone (651) 702-0750

Other identifiers 1

IdentifierTypeStateIssuer
286325100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100217000807 MN Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 3779470695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otolaryngology and Head and Neck Surgery PAGroup PAC ID 1658268651, 38 clinicians

Practice addresses (Care Compare)

11020 161St St W
Lakeville, MN 55044-6507
Phone (651) 702-0750

215 Radio Dr
Suite 202
Woodbury, MN 55125-5805

217 Radio Dr
Woodbury, MN 55125-5805
Phone (651) 702-0750

3590 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 702-0750

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions27
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36117MNMDFacial Plastic Surgery Physician
40701-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Ancillary Services, Inc CurrentSince Jul 1, 1996 Accepting new patients

Locations

3460 Promenade Ave
Eagan, MN 55123

11020 161st St W
Lakeville, MN 55044

3590 Arcade St
Vadnais Heights, MN 55127

217 Radio Dr
Woodbury, MN 55125

2080 Woodwinds Dr
Ste 240
Woodbury, MN 55125

215 Radio Dr
Ste 202
Woodbury, MN 55125
Phone (651) 867-9007

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1043256357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 RADIO DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255822",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255805",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2651 Hillcrest Dr Ste 302",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540169919",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3590 Arcade St",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551277135",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3460 Promenade Ave",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "551234404",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11020 161st St W",
            "address_purpose": "LOCATION",
            "city": "Lakeville",
            "state": "MN",
            "postal_code": "550446507",
            "country_code": "US",
            "telephone_number": "651-702-0750",
            "fax_number": "651-645-6166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "36117",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WI",
            "license": "40701-20",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "40701-20",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MN",
            "license": "36117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286325100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.