Active NPI
Laura Olson, PA-C
- Physician Assistant
- Blaine, MN
National Provider Identifier
1396405304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13849
- Practice address
- 11091 Ulysses St NE
Blaine, MN 55434-4237 - Phone
- (612) 879-1000
- NPI assigned
- Dec 19, 2021
- Last updated
- Aug 23, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13849 | MN | Primary |
Addresses
Primary practice location
11091 Ulysses St NE
Blaine, MN 55434-4237
Mailing address
3601 Minnesota Drive Suite 200
Bloomington, MN 55435-4237
Phone (612) 879-1000
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2828 Chicago Ave
Suite 200
Minneapolis, MN 55407-4187
Phone (612) 879-1000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13849 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quest Diagnostics LLC Il | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Bloomington, MN
- NPI 1710098306
-
- Clinical Medical Laboratory
- Chicago, IL
- NPI 1669298055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1396405304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 MINNESOTA DRIVE SUITE 200",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554354237",
"telephone_number": "612-879-1000",
"fax_number": "612-879-9116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11091 ULYSSES ST NE",
"city": "BLAINE",
"state": "MN",
"postal_code": "554344237",
"telephone_number": "612-879-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "LAURA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-19",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "13849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blaine, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.