Active NPI
Richard H Tholen, MD
- Plastic Surgery Physician
- Minneapolis, MN
National Provider Identifier
1104893643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 026478
- Practice address
- 4825 Olson Memorial Hwy
Suite 200
Minneapolis, MN 55422 - Phone
- (763) 545-0443
- Fax
- (763) 545-2784
- NPI assigned
- Mar 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 026478 | MN | Primary |
Addresses
Primary practice location
4825 Olson Memorial Hwy
Suite 200
Minneapolis, MN 55422
Mailing address
4825 Olson Memorial Hwy
Suite 200
Minneapolis, MN 55422
Phone (763) 545-0443
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00836TH | Other | MN | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 15, 2015 through Dec 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26478 | MN | MD | Clinical Social Worker |
| 026478 | MN | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1104893643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4825 OLSON MEMORIAL HWY",
"address_2": "SUITE 200",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55422",
"telephone_number": "763-545-0443",
"fax_number": "763-545-2784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4825 OLSON MEMORIAL HWY",
"address_2": "SUITE 200",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55422",
"telephone_number": "763-545-0443",
"fax_number": "763-545-2784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOLEN",
"first_name": "RICHARD",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-03",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MN",
"license": "026478",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "00836TH",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
- Sherry Lee Thistle, LICSW
- William Tyler Thoen, RDN
- Venkatakrishna Narasimhamurthy Tholakanahalli, MBBS
- Krista Marie Thole, OT
- Jillian Theresa Tholen, M.S., R.D.N., L.D.
- Hailey Grace Thom
- Michael John Thomann
- Nickitas Bernard-Aristides Thomarios, DO
- Thomas Paul Carrillo PH.D.,L.P.P.a.
- Susan Thomas-McGregor, M.A., LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.