Individual provider Active NPI

Loyd B Olson III, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Phoenix, AZ
National Provider Identifier
1306165733
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5366
NPI assigned
May 25, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (402) 416-4769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150928002498 AZ Practitioner - General Surgery 9133437932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Creighton University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 E Main St
Suite a
Payson, AZ 85541-5618
Phone (928) 596-4700

122 E Main St
Payson, AZ 85541-5574
Phone (928) 596-4600

127 E Main St
Suite C
Payson, AZ 85541-5646
Phone (928) 471-3450

37100 N Gantzel Rd
Suite 201
San Tan Valley, AZ 85140-7352
Phone (480) 394-4469

807 S Ponderosa St
Payson, AZ 85541-5542
Phone (928) 471-3222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.12 of 100Reported as group
Quality
76.35
Promoting interoperability
99
Improvement activities
40
Cost
71.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy61
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux41
Removal of tissue14
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2015 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

122 E Main St
Payson, AZ 85541
Phone (928) 474-2888

127 E Main St
Ste C
Payson, AZ 85541
Phone (928) 471-3450

807 S Ponderosa St
Payson, AZ 85541
Phone (520) 474-3222

120 E Main St
Ste A
Payson, AZ 85541
Phone (928) 474-9744

37100 N Gantzel Rd
Ste 201
San Tan Vly, AZ 85140
Phone (480) 394-4469

Interoperability endpoints

  • Direct secure messaging: loyd.olson.1@1564.direct.athenahealth.com

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": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1306165733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "402-416-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "LOYD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.