Individual provider Active NPI

Nolan S Shen, DO

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1104446772
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
82080 Issued in MN
Practice address
2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Phone
(651) 292-2000
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 81796-21 WI
Diagnostic Radiology Physician 2085R0202X 82080 MN Primary
Neuroradiology Physician 2085N0700X 82080 MN
Diagnostic Radiology Physician 2085R0202X 24207 ND
Neuroradiology Physician 2085N0700X 24207 ND
Diagnostic Radiology Physician 2085R0202X 81796-21 WI

Addresses

Primary practice location

2355 Hwy 36 W
Ste. 100
Roseville, MN 55113

Mailing address

2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Phone (651) 292-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, ND3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20260616000730 WI Practitioner - Diagnostic Radiology 4284053661
I20260616000765 MN Practitioner - Diagnostic Radiology 4284053661
I20260624004283 ND Practitioner - Diagnostic Radiology 4284053661

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703

2355 Hwy 36 W
Suite 100
Roseville, MN 55113-3905

2355 Hwy 36 W 100
Roseville, MN 55113-3905

500 S Maple St
Waconia, MN 55387-1752

900 2ND Ave
Madison, MN 56256-1006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81796WIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Imaging, LLC CurrentSince Aug 3, 2026 Accepting new patients

Locations

8990 Springbrook Dr NW
Ste 140
Minneapolis, MN 55433
Phone (763) 792-1900

2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000

Organizations & group practices 1

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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1104446772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HWY 36 W",
            "address_2": "STE. 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-292-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "NOLAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WI",
            "license": "81796-21",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "82080",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "82080",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ND",
            "license": "24207",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "ND",
            "license": "24207",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "81796-21",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.