Individual provider Active NPI

Jakub Tolar, MD

  • Pediatric Hematology & Oncology Physician
  • Minneapolis, MN
National Provider Identifier
1962591974
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
42278 Issued in MN
Practice address
516 Delaware Street SE
PWB 5TH Floor, Ste 5-100 Clinic 5B
Minneapolis, MN 55455
Phone
(612) 273-2800
NPI assigned
Oct 11, 2006
Last updated
Nov 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 42278 MN
Pediatric Hematology & Oncology Physician 2080P0207X 42278 MN Primary

Addresses

Primary practice location

516 Delaware Street SE
PWB 5TH Floor, Ste 5-100 Clinic 5B
Minneapolis, MN 55455

Mailing address

420 Delaware Street SE
University of Minnesota Physicians
Minneapolis, MN 55455
Phone (612) 273-2800

Other identifiers 9

IdentifierTypeStateIssuer
0063240MedicaidMT
140923OtherMNUCARE
HP33585OtherMNHEALTH PARTNERS
1028458OtherMNPREFERRED ONE
131326OtherMNFAIRVIEW
1384114OtherFMARAZ
288656100MedicaidMN
12-09026OtherMNMEDICA PRIMARY
12-02535OtherMNMEDICA CHOICE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100208000142 MN Practitioner - Pediatric MedicinePractitioner - Hematology/Oncology 8123161502 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42278MNMDPediatric Hematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians CurrentSince Dec 4, 2009 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
University of Minnesota Physicians CurrentSince Dec 4, 2009 Accepting new patients
Fairview Health Services PastSince Jan 1, 2017 Accepting new patients

Locations

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483

516 Delaware St SE
Fl 5
Minneapolis, MN 55455
Phone (612) 273-2800

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0331

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

Interoperability endpoints

  • Direct secure messaging: jtolar148150@fairview.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fairview Northland Regional HospitalPrinceton, MN, CCN 240141 Hospital Corporate Director Jan 1, 2017

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1962591974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 DELAWARE STREET SE",
            "address_2": "PWB 5TH FLOOR, STE 5-100 CLINIC 5B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-273-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLAR",
        "first_name": "JAKUB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "42278",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MN",
            "license": "42278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063240",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140923",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP33585",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1028458",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAIRVIEW",
            "identifier": "131326",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ",
            "identifier": "1384114",
            "state": "FM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288656100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "12-09026",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "12-02535",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.