Individual provider Active NPI

Marc William Nolan, D.O.

  • Rheumatology Physician
  • Woodbury, MN
National Provider Identifier
1679916837
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
59769 Issued in MN
Practice address
4040 Radio Dr
Woodbury, MN 55129-3237
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Apr 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 74850-21 WI
Rheumatology Physician 207RR0500X 59769 MN Primary

Addresses

Primary practice location

4040 Radio Dr
Woodbury, MN 55129-3237

Mailing address

4200 Dahlberg Dr Ste 300
Golden Valley, MN 55422-4841
Phone (952) 512-5600

Other practice location 1

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160330001915 MN Practitioner - RheumatologyPractitioner - Internal Medicine 8224335633 Reassigns benefits to 4 organizations
I20230614001517 WI Practitioner - RheumatologyPractitioner - Internal Medicine 8224335633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 101
Hudson, WI 54016-9919
Phone (800) 423-1088

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59769MNMDRheumatology Physician
74850-21WIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jul 1, 2023 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Feb 10, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Infinite Health Collaborative, PA Rheumatology CurrentSince Jul 1, 2023 Accepting new patients
Group Health, Inc. CurrentSince Aug 25, 2018 Accepting new patients
Fairview Express Care CurrentSince Feb 27, 2016 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Feb 10, 2023 Accepting new patients
Fairview Health Services CurrentSince Feb 27, 2016 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

2651 Hillcrest Dr
Ste 101
Hudson, WI 54016
Phone (800) 423-1088

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1679916837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 RADIO DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551293237",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554151623",
            "country_code": "US",
            "telephone_number": "612-873-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "MARC",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WI",
            "license": "74850-21",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "59769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.