Jon Olof Olson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2055 Issued in MN

Practice address

1210 County Road E W
Arden Hills, MN 55112-3783

Phone

(651) 523-8400

Fax

(651) 484-9650

NPI assigned

Feb 2, 2006

Sex

Male

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1881666162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34 AVE S",
            "address_2": "MC21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-7172",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 COUNTY ROAD E W",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551123783",
            "telephone_number": "651-523-8400",
            "fax_number": "651-484-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JON",
        "middle_name": "OLOF",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388323000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mattie Virginia Obregon
• Diana Yaritsel Ocampo-Valencia
• Celeste Oliveros
• Bradley Kent Olson, MD
• Jon Duncan Olson
• Aisha Abdikadir Omar
• Sandra Bisinga Omwenga
• Orthocor Medical, Inc
• Orthodontic Care Group
• Awo Ahmed Osman

• Optometrist in Arden Hills, MN
• Providers in Arden Hills, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.