Individual provider Active NPI

Danielle Therese Olsen, MD

  • Family Medicine Physician
  • St Francis, WI
National Provider Identifier
1770164154
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
78008 Issued in WI
Practice address
2000 E Layton Ave
St Francis, WI 53235-6053
Phone
(414) 744-6589
NPI assigned
Apr 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 78008 WI Primary

Addresses

Primary practice location

2000 E Layton Ave
St Francis, WI 53235-6053

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2901 W Oklahoma Ave
Milwaukee, WI 53215-4329
Phone (414) 649-6732

Other identifiers 1

IdentifierTypeStateIssuer
100284936MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dolsenmcauliffe305951@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20240919000019 WI Practitioner - Family Practice 8224489695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC Family Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

2000 E Layton Ave
Ste 100
St Francis, WI 53235
Phone (414) 481-8828

Interoperability endpoints

  • Direct secure messaging: dolsenmcauliffe305951@direct.myadvocateaurora.org

Organizations & group practices 1

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 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": "1618704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1770164154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAYTON AVE",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356053",
            "telephone_number": "414-744-6589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154329",
            "country_code": "US",
            "telephone_number": "414-649-6732",
            "fax_number": "414-649-5840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "DANIELLE",
        "middle_name": "THERESE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-18",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "78008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100284936",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dolsenmcauliffe305951@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2000 E Layton Ave",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

Verify at the official NPI Registry.