Theresa M Wollan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32793 Issued in MN

Practice address

3550 Labore Rd Ste 7
Vadnais Heights, MN 55110-5113

Phone

(651) 766-0520

Fax

(651) 766-9451

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

University of Minnesota Medical School, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Healthservices Minnesota PAGroup PAC ID 1355369018, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Fairview Home Health - West, LLC Home health agency, Saint Paul, MN, CCN 247078
• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
• M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.wollan@entira.eclinicaldirectplus.com

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.

• Family Healthservices Minnesota, P.a.

  • Family Medicine Physician
  • Hugo, MN
  • NPI 1639359359
  Medicare reassignment Care Compare group NPD
• East Metro Family Practice, P.a.

  • Family Medicine Physician
  • Inver Grove Heights, MN
  • NPI 1760600258
  NPD (past)
• Family Healthservices Minnesota, P.a.

  • Family Medicine Physician
  • Vadnais Heights, MN
  • NPI 1528248259
  NPD (past)
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  NPD (past)

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

• Accentcare Fairview Home Health - West, LLC

  • Home Health Agency
  • Saint Paul, MN
  • NPI 1477169233
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1770599458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL STE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172092",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 LABORE RD STE 7",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105113",
            "telephone_number": "651-766-0520",
            "fax_number": "651-766-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLAN",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "32793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "584098800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daren J Wickum, M.D.
• Lori Ab Wiggenhorn, MA, LP
• Natia Wilcek, LICSW
• Hope Wilkins, CMT
• Reed Conly Williams, M.D.
• Paul Severin Wood, DC
• Colleen E Woodington, PA
• Pamela D Wright, OTR/L, CHT
• Dee Xiong
• Grace C Yackly, DPT

• Family Medicine Physician in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.