NPIMap

Individual provider Active NPI

Ty Conrad Olson

  • Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1609365501
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD2024-0401 Issued in NM
Practice address
Msc10 5610
Albuquerque, NM 81731
Phone
(505) 272-4161
Fax
(505) 272-2776
NPI assigned
May 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD2024-0401 NM Primary

Addresses

Primary practice location

Msc10 5610
Albuquerque, NM 81731

Mailing address

1701 W Charleston Blvd Ste 400
Las Vegas, NV 89102-2320

Other practice location 1

1701 W Charleston Blvd Ste 400
Las Vegas, NV 89102-2320
Phone (702) 671-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240815002853 NM Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7911257480 Reassigns benefits to 1 organization
I20260121002564 NV Practitioner - Critical Care (Intensivists)Practitioner - General Surgery 7911257480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: General Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2024-0401NMMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Dec 18, 2025 Accepting new patients
Unlv Medicine CurrentSince Dec 18, 2025 Accepting new patients
Unm Medical Group, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Unm Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Unm Hospital Past Accepting new patients

Locations

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

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 and National Provider Directory roles.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1609365501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W CHARLESTON BLVD STE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC10 5610",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "81731",
            "telephone_number": "505-272-4161",
            "fax_number": "505-272-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 W Charleston Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022320",
            "country_code": "US",
            "telephone_number": "702-671-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TY",
        "middle_name": "CONRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2024-0401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.