NPIMap

Individual provider Active NPI

Cory Lynn Olson, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1386761690
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0780 Issued in SD
Practice address
1210 W 18TH St Ste 100
Van Demark Building
Sioux Falls, SD 57104-9890
Phone
(605) 312-8500
Fax
(605) 312-8501
NPI assigned
Mar 23, 2007
Last updated
May 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0780 SD Primary

Addresses

Primary practice location

1210 W 18TH St Ste 100
Van Demark Building
Sioux Falls, SD 57104-9890

Mailing address

1210 W 18TH St Ste 100
Van Demark Building
Sioux Falls, SD 57104-9890
Phone (605) 312-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110906000692 SD Practitioner - Physician Assistant 0547430266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as group
Quality
69.08
Promoting interoperability
100
Improvement activities
40
Cost
69.44

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0780SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Physician Assistant CurrentSince Mar 7, 2017 Accepting new patients
Sanford Clinic CurrentSince Mar 7, 2017 Accepting new patients
Sanford Medical Center CurrentSince Mar 7, 2017 Accepting new patients
Sanford Clinic CurrentSince Mar 7, 2017 Accepting new patients
Sanford Clinic Past Accepting new patients
Sanford Clinic Past Accepting new patients

Locations

1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

Organizations & group practices 7

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.

Hospital & facility affiliations 32

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1386761690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE 100",
            "address_2": "VAN DEMARK BUILDING",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571049890",
            "telephone_number": "605-312-8500",
            "fax_number": "605-312-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W 18TH ST STE 100",
            "address_2": "VAN DEMARK BUILDING",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571049890",
            "telephone_number": "605-312-8500",
            "fax_number": "605-312-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CORY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.