Individual provider Active NPI

Robert J Olson, MD

  • Psychiatry Physician
  • Mankato, MN
National Provider Identifier
1356320279
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
31335 Issued in MN
Practice address
1400 E Madison Ave
Suite 352
Mankato, MN 56001-5473
Phone
(507) 387-3195
NPI assigned
Jan 10, 2006
Last updated
Jul 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 31335 MN Primary

Addresses

Primary practice location

1400 E Madison Ave
Suite 352
Mankato, MN 56001-5473

Mailing address

PO Box 8674
1230 E Main St
Mankato, MN 56002-8674
Phone (507) 625-1811

Other identifiers 9

IdentifierTypeStateIssuer
41084933956001C179OtherCHAMPUS
992446OtherMNAMERICAS PPO
HP36646OtherMNHEALTH PARTNERS
NA2950902011OtherMNPREFERRED ONE
389R3OLOtherMNBCBS
P00106215OtherRR MEDICARE
123583OtherMNUCARE
0571331MedicaidIA
179319500MedicaidMN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robertolson@mklt.allscriptsdirect.net Direct

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
I20070816000264 MN Practitioner - Psychiatry 7012009327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Minnesota Medical School, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mankato Clinic LTDGroup PAC ID 5597677955, 243 clinicians

Practice addresses (Care Compare)

1230 E Main St
Mankato, MN 56001-5066
Phone (507) 389-8509

1230 Main St E
PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811

1360 Adams St
Mankato, MN 56001-4298
Phone (507) 388-9292

1400 Madison Ave
Suite 352
Mankato, MN 56001-4458
Phone (507) 625-1811

1411 Premier Dr
Mankato, MN 56001-6076
Phone (507) 388-6000

1421 Premier Dr
Mankato, MN 56001-6076
Phone (507) 385-4000

1431 Premier Dr
Mankato, MN 56001-6076
Phone (507) 386-6750

1431 Premier Dr MRI Dept
Orthopaedic and Fracture Clinic
Mankato, MN 56001-6076
Phone (507) 386-6750

1575 Lookout Dr
North Mankato, MN 56003-2503
Phone (507) 625-5027

1901 Old Minnesota Ave
Saint Peter, MN 56082-1763
Phone (504) 934-2325

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Clinic LTD Psychiatry CurrentSince Jan 1, 2002 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

1400 Madison Ave
Ste 352
Mankato, MN 56001
Phone (507) 387-3195

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1356320279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8674",
            "address_2": "1230 E MAIN ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560028674",
            "telephone_number": "507-625-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E MADISON AVE",
            "address_2": "SUITE 352",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015473",
            "telephone_number": "507-387-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "31335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "41084933956001C179",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAS PPO",
            "identifier": "992446",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP36646",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA2950902011",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "389R3OL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00106215",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "123583",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0571331",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179319500",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robertolson@mklt.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Madison Ave",
            "address_2": "Suite 352",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560015473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.