NPIMap

Individual provider Active NPI

Jeremiah Olson, M.D.

  • Surgery Physician
  • Wausau, WI
National Provider Identifier
1447593835
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
42511 Issued in WI
Practice address
2606 Stewart Ave Ste 200
Wausau, WI 54401-5449
Phone
(715) 847-2022
NPI assigned
Apr 3, 2013
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 42511 WI Primary

Addresses

Primary practice location

2606 Stewart Ave Ste 200
Wausau, WI 54401-5449

Mailing address

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022

Other practice location 1

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Other practice location 2

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Other practice location 3

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

Other identifiers 1

IdentifierTypeStateIssuer
100078088MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180711003263 WI Practitioner - General Surgery 6204182835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Surgical Associates, S.C.Group PAC ID 3072400019, 26 clinicians

Practice addresses (Care Compare)

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 847-2022

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.56 of 100Reported as group
Quality
90.89
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42511WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates, S.C. Surgery CurrentSince Aug 1, 2018 Accepting new patients

Locations

5409 Vern Holmes Dr
Stevens Point, WI 54482
Phone (715) 342-1015

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

2606 Stewart Ave
Wausau, WI 54401

2606 Stewart Ave
Ste 200
Wausau, WI 54401
Phone (715) 847-2022

Interoperability endpoints

  • Direct secure messaging: jolson138063@direct.aspirus.org

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.

Hospital & facility affiliations 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1447593835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544017803",
            "telephone_number": "715-847-2022",
            "fax_number": "715-847-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 STEWART AVE STE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015449",
            "telephone_number": "715-847-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 N Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "178229800",
            "country_code": "US",
            "telephone_number": "570-271-6211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Pine Ridge Blvd",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "54401",
            "country_code": "US",
            "telephone_number": "715-847-2022",
            "fax_number": "715-847-2775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JEREMIAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "42511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100078088",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.