Individual provider Active NPI

Tracy L Olson, NP

  • Adult Health Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1700133808
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704260533 Issued in MI
Practice address
37669 Pembroke Ave
Livonia, MI 48152-1050
Phone
(734) 793-6500
NPI assigned
Aug 7, 2012
Last updated
Aug 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704260533 MI Primary

Addresses

Primary practice location

37669 Pembroke Ave
Livonia, MI 48152-1050

Mailing address

1256 Wedgewood Cir
Saline, MI 48176-9276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130121000114 MI Practitioner - Nurse Practitioner 8022261262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Mercy HospitalGroup PAC ID 3779489281, 69 clinicians

Practice addresses (Care Compare)

5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3456

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704260533MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Mercy Livingston Hospital CurrentSince Aug 18, 2022 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Aug 18, 2022 Accepting new patients
St Joseph Mercy Hospital CurrentSince Aug 18, 2022 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
St Joseph Mercy Hospital CurrentSince Aug 18, 2022 Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients
Michigan Pain Institute, PLLC Past Accepting new patients
St Joseph Mercy Hospital Past Accepting new patients

Locations

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

20555 Victor Pkwy
Stop 3A
Livonia, MI 48152

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5333 McAuley Dr
Rm 1000
Ypsilanti, MI 48197
Phone (734) 712-5898

Interoperability endpoints

  • Direct secure messaging: tolson36590@direct.trinity-health.org

Organizations & group practices 8

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 2

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": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1700133808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 WEDGEWOOD CIR",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481769276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37669 PEMBROKE AVE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521050",
            "telephone_number": "734-793-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "TRACY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704260533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.