NPIMap

Individual provider Active NPI

Kyle L Olson, P.A.-C.

  • Physician Assistant
  • Monticello, MN
National Provider Identifier
1982611380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9490 Issued in MN
Practice address
1107 Hart Blvd
Monticello, MN 55362-8538
Phone
(763) 295-2921
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9490 MN Primary

Addresses

Primary practice location

1107 Hart Blvd
Monticello, MN 55362-8538

Mailing address

1700 Highway 25 N
Buffalo, MN 55313-1930
Phone (763) 682-1313

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
I20100511000823 MN Practitioner - Physician Assistant 7416085527 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

13819 Hanson Blvd NW
Andover, MN 55304-7608
Phone (612) 626-5775

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

6401 France Ave S
Edina, MN 55435-2104
Phone (952) 924-5000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Sep 14, 2013 Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Sep 14, 2013 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics CurrentSince Oct 1, 2020 Accepting new patients
Fairview Clinics Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

10961 Club West Pkwy
Minneapolis, MN 55449
Phone (763) 572-5700

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

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

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Interoperability endpoints

  • Direct secure messaging: kolson309054@fairview.direct-ci.com

Organizations & group practices 12

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 8

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982611380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 HIGHWAY 25 N",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131930",
            "telephone_number": "763-682-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 HART BLVD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628538",
            "telephone_number": "763-295-2921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "KYLE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

Verify at the official NPI Registry.