Individual provider Active NPI

Charles E Olson, MD

  • Interventional Cardiology Physician
  • Omaha, NE
National Provider Identifier
1699736553
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
18134 Issued in NE
Practice address
1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114
Phone
(402) 391-5055
Fax
(402) 391-5053
NPI assigned
Mar 30, 2006
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 18134 NE
Interventional Cardiology Physician 207RI0011X 18134 NE Primary

Addresses

Primary practice location

1120 N 103Rd PLZ
Suite 100
Omaha, NE 68114-1114

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
1699736553MedicaidIA
100264481-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20100830000543 NE Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 4082507256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Nebraska College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians
Nebraska Methodist HospitalGroup PAC ID 6901707447, 132 clinicians

Practice addresses (Care Compare)

10060 Regency Cir
Omaha, NE 68114-3732
Phone (402) 354-1570

1120 N 103Rd Plaza
200 Cardiothoracic Surgery
Omaha, NE 68114-1119
Phone (402) 354-0400

1120 N 103Rd PLZ
Omaha, NE 68114-1119

16120 W Dodge Rd
Omaha, NE 68118-2049
Phone (402) 354-0550

707 N 190TH Plaza
Elkhorn, NE 68022-3974
Phone (402) 815-4000

717 N 190TH Plaza
Suite 2400
Elkhorn, NE 68022-3974
Phone (402) 815-1901

8303 Dodge St
Omaha, NE 68114-4108
Phone (402) 354-8163

8303 W Dodge St
Omaha, NE 68114-4108
Phone (402) 354-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital Cardiovascular Disease CurrentSince Oct 1, 2010 Accepting new patients
Physicians Clinic Inc CurrentSince Dec 31, 2014 Accepting new patients

Locations

631 N 8th St
Mo Valley, IA 51555
Phone (712) 642-2784

707 N 190th Plz
Elkhorn, NE 68022
Phone (402) 354-4000

426 E 22nd St
Ste 100
Fremont, NE 68025
Phone (402) 727-7796

10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405

1120 N 103rd Plz
Ste 100
Omaha, NE 68114
Phone (402) 391-5055

16120 W Dodge Rd
Omaha, NE 68118
Phone (402) 354-0550

6901 N 72nd St
Omaha, NE 68122
Phone (402) 572-2121

6901 N 72nd St
Ste 3300N
Omaha, NE 68122
Phone (402) 572-3300

8111 Dodge St
Ste 308
Omaha, NE 68114
Phone (402) 354-8181

8303 Dodge St
Ste LL6
Omaha, NE 68114
Phone (402) 354-4104

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1699736553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N 103RD PLZ",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681141114",
            "telephone_number": "402-391-5055",
            "fax_number": "402-391-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "CHARLES",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NE",
            "license": "18134",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NE",
            "license": "18134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699736553",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100264481-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.