NPIMap

Individual provider Active NPI

Thomas Haroldson, MD

  • Family Medicine Physician
  • Vadnais Heights, MN
National Provider Identifier
1942697131
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60762 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
Apr 25, 2015
Last updated
Oct 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PT15068 ND
Family Medicine Physician 207Q00000X 60762 MN Primary

Addresses

Primary practice location

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

Mailing address

2025 Sloan PL Ste 35
Saint Paul, MN 55117-2092
Phone (651) 772-1572

Other practice location 1

4786 Banning Ave
White Bear Lake, MN 55110-3264
Phone (651) 426-6402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726000761 MN Practitioner - Family PracticePractitioner - Sports Medicine 0648563817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3550 Labore Rd
Suite 7
Vadnais Heights, MN 55110-5113
Phone (651) 788-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PT15068NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Sep 30, 2019 Accepting new patients
Family Healthservices Minnesota, P.a. Family Medicine CurrentSince Sep 30, 2019 Accepting new patients
Minnhealth Family Physicians, P.a. Family Medicine Past Accepting new patients
Family Healthservices Minnesota, P.a. Family Medicine Past Accepting new patients

Locations

2025 Sloan Pl
Ste 35
Saint Paul, MN 55117
Phone (651) 772-1572

2601 Centennial Dr
Ste 100
Saint Paul, MN 55109
Phone (651) 777-7414

3550 Labore Rd
Ste 7
Vadnais Heights, MN 55110
Phone (651) 766-0520

4786 Banning Ave
White Bear Lake, MN 55110
Phone (651) 426-6402

Interoperability endpoints

  • Direct secure messaging: thomas.haroldson@entira.eclinicaldirectplus.com

Organizations & group practices 4

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": "1429920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1942697131",
    "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": [
        {
            "address_1": "4786 Banning Ave",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103264",
            "country_code": "US",
            "telephone_number": "651-426-6402",
            "fax_number": "651-429-3402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAROLDSON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-25",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "PT15068",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "60762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

Verify at the official NPI Registry.