Shawn Phillip Olson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

TRL 12384 Issued in ND

Practice address

501 N Columbia Rd Stop 9037
Dept of Surgery RM 5107,University of North Dakota SMHS
Grand Forks, ND 58202-9037

Phone

(701) 777-3067

Fax

(701) 777-2609

NPI assigned

Jul 18, 2012

Last updated

Jul 18, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

General Surgery

Education

University of Minnesota, Duluth School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grand Itasca Clinic and HospitalGroup PAC ID 8123939550, 328 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Itasca Clinic and Hospital Hospital, Grand Rapids, MN, CCN 240064

Merit-based Incentive Payment System (MIPS)

Final score

92.35 of 100Reported as group

Quality

88.69

Promoting interoperability

100

Improvement activities

40

Cost

76.65

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: solson199498@fairview.direct-ci.com

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.

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment Care Compare group NPD
• Grand Itasca Clinic and Hospital

  dba Grand Itasca Pharmacy

  • Community/Retail Pharmacy
  • Grand Rapids, MN
  • NPI 1225441157
  NPD

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

• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1568717262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N COLUMBIA RD STOP 9037",
            "address_2": "DEPT OF SURGERY RM 5107,UNIVERSITY OF NORTH DAKOTA SMHS",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029037",
            "telephone_number": "701-777-3067",
            "fax_number": "701-777-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N COLUMBIA RD STOP 9037",
            "address_2": "DEPT OF SURGERY RM 5107,UNIVERSITY OF NORTH DAKOTA SMHS",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582029037",
            "telephone_number": "701-777-3067",
            "fax_number": "701-777-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SHAWN",
        "middle_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "TRL 12384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Diane Olson, PT
• Kristie Olson
• Laura Olson
• Neil I Olson, LAC
• Robert A Olson, D.D.S.
• Wade Alexander Olson, FNP-C
• William A Olson, DO
• William Harold Olson, DDS
• Bonnie B Omdahl, MD
• Nicole Marie Oncken, PHARMD, RPH

• Surgery Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2012; 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.

Verify at the official NPI Registry.