Individual provider Active NPI

Paul Lewis Olson, MD

  • Nephrology Physician
  • Chanhassen, MN
National Provider Identifier
1184685844
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
27363 Issued in MN
Practice address
7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone
(952) 934-0570
Fax
(952) 906-7837
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 27363 MN Primary

Addresses

Primary practice location

7907 Powers Blvd
Chanhassen, MN 55317-9502

Mailing address

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Other identifiers 1

IdentifierTypeStateIssuer
586268000MedicaidMN

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
I20060223000266 MN Practitioner - Internal MedicinePractitioner - Nephrology 7517973894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
University of Minnesota Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

560 S Maple St
Waconia, MN 55387-1757

7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27363MNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgeview Medical Center Current Accepting new patients
Ridgeview Medical Center CurrentSince Oct 2, 2017 Accepting new patients
Ridgeview Medical Center CurrentSince Oct 2, 2017 Accepting new patients

Locations

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 115N
Chaska, MN 55318
Phone (952) 361-2450

4695 Shoreline Dr
Spring Park, MN 55384
Phone (952) 442-7890

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

560 S Maple St
Ste 220
Waconia, MN 55387
Phone (952) 442-8011

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1184685844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7907 POWERS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179502",
            "telephone_number": "952-934-0570",
            "fax_number": "952-906-7837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7907 POWERS BLVD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179502",
            "telephone_number": "952-934-0570",
            "fax_number": "952-906-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "PAUL",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "27363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "586268000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

Verify at the official NPI Registry.