NPIMap

Individual provider Active NPI

Timothy A Olson, MD

  • Obstetrics & Gynecology Physician
  • Monticello, MN
National Provider Identifier
1659388064
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35964 Issued in MN
Practice address
1001 Hart Blvd
Suite 100
Monticello, MN 55362-8670
Phone
(763) 295-2921
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35964 MN Primary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 35964 MN

Addresses

Primary practice location

1001 Hart Blvd
Suite 100
Monticello, MN 55362-8670

Mailing address

1700 Highway 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

Other practice location 1

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 271-2846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100511000339 MN Practitioner - Obstetrics/Gynecology 3678485125 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Health System-NR LLCGroup PAC ID 3870739410, shared by 4 NPIs, 63 clinicians
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

1013 Hart Blvd
Monticello, MN 55362-8575
Phone (763) 295-2945

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35964MNMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Health System-NR LLC Current Accepting new patients
North Memorial Health Care CurrentSince Jan 1, 2013 Accepting new patients
North Memorial Health Care CurrentSince Jan 1, 2013 Accepting new patients
Centracare Health System-NR LLC CurrentSince Nov 1, 2018 Accepting new patients

Locations

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

3300 Oakdale Ave N
Apt 180
Robbinsdale, MN 55422
Phone (763) 581-5140

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

Interoperability endpoints

  • Direct secure messaging: tolson22554@direct.centracare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1659388064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 HART BLVD",
            "address_2": "SUITE 100",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628670",
            "telephone_number": "763-295-2921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Hart Blvd",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "MN",
            "postal_code": "553628575",
            "country_code": "US",
            "telephone_number": "763-271-2846",
            "fax_number": "763-271-2847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "35964",
            "primary": true
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "MN",
            "license": "35964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.