Active NPI
Kristina M Olstad, PA
- Physician Assistant
- Beach, ND
National Provider Identifier
1609872043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAC0347
- Practice address
- 95 2ND St NW
Beach, ND 58621 - Phone
- (701) 872-3777
- NPI assigned
- Jun 21, 2005
- Last updated
- Jan 8, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0347 | ND | Primary |
| Medical Physician Assistant | 363AM0700X | PAC0347 | ND |
Addresses
Primary practice location
95 2ND St NW
Beach, ND 58621
Mailing address
95 2ND St NW
Beach, ND 58621
Phone (701) 872-3777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1454867 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- 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, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
683 State Ave
Dickinson, ND 58601-4660
Phone (701) 483-9400
95 NW 2ND St
Beach, ND 58621
Phone (701) 872-3777
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1824 | WI | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Joseph's Hospital and Health Center | Current | Accepting new patients | |
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Coal Country Community Health Center | Past | Accepting new patients | |
| St. Joseph's Hospital and Health Center | Past | Accepting new patients |
Locations
7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033
2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000
Organizations & group practices 6
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.
-
dba CHI St Alexius Health Dickinson Medical Clinic
- Clinic/Center
- Dickinson, ND
- NPI 1730464108
-
dba CHI St. Alexius Health Beach Family Clinic
- Rural Health Clinic/Center
- Beach, ND
- NPI 1669491262
-
- Federally Qualified Health Center (FQHC)
- Beulah, ND
- NPI 1942288329
-
dba CHI St Alexius Health Dickinson
- Critical Access Hospital
- Dickinson, ND
- NPI 1992947956
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHI St Alexius Health Dickinson
- Critical Access Hospital
- Dickinson, ND
- NPI 1992947956
-
- Medicare Defined Swing Bed Hospital Unit
- Glendive, MT
- NPI 1073523635
-
- Critical Access Hospital
- Glendive, MT
- NPI 1376552893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1609872043",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95 2ND ST NW",
"city": "BEACH",
"state": "ND",
"postal_code": "58621",
"telephone_number": "701-872-3777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 2ND ST NW",
"city": "BEACH",
"state": "ND",
"postal_code": "58621",
"telephone_number": "701-872-3777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSTAD",
"first_name": "KRISTINA",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-21",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": "PAC0347",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ND",
"license": "PAC0347",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1454867",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beach, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.