Individual provider Active NPI

Michelle M Olson, MD

  • Colon & Rectal Surgery Physician
  • Dallas, TX
National Provider Identifier
1366405102
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
U0412 Issued in TX
Practice address
122 W Colorado Blvd
Dallas, TX 75208-2382
Phone
(214) 947-6700
Fax
(214) 947-6701
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X MD424639 PA
Colon & Rectal Surgery Physician 208C00000X 036129211 IL
Colon & Rectal Surgery Physician 208C00000X U0412 TX Primary

Addresses

Primary practice location

122 W Colorado Blvd
Dallas, TX 75208-2382

Mailing address

122 W Colorado Blvd
Dallas, TX 75208-2382
Phone (214) 947-6700

Other practice location 1

221 W. Colorado Blvd.
Pavilion II Suite 431
Dallas, TX 75208
Phone (214) 943-1171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221213000684 TX Practitioner - Colorectal Surgery (Proctology) 4981630613 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Drexel University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

221 W Colorado Blvd
Suite 644
Dallas, TX 75208-2316
Phone (214) 943-2200

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth Current Accepting new patients
Physician Associates of Southwest Dallas CurrentSince Dec 1, 2022 Accepting new patients
Medhealth CurrentSince Dec 1, 2022 Accepting new patients
Geisinger Clinic Selinsgrove Past Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

221 W Colorado Blvd
Ste 431
Dallas, TX 75208
Phone (214) 943-1171

221 W Colorado Blvd
Ste 644
Dallas, TX 75208
Phone (214) 942-8300

122 W Colorado Blvd
Dallas, TX 75208
Phone (214) 947-6555

Organizations & group practices 5

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1366405102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W COLORADO BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082382",
            "telephone_number": "214-947-6700",
            "fax_number": "214-947-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W COLORADO BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082382",
            "telephone_number": "214-947-6700",
            "fax_number": "214-947-6701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 W. Colorado Blvd.",
            "address_2": "Pavilion II Suite 431",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75208",
            "country_code": "US",
            "telephone_number": "214-943-1171",
            "fax_number": "972-298-2148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2025-05-02",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "PA",
            "license": "MD424639",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036129211",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "U0412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.