NPIMap

Individual provider Active NPI

Jeremy David Olsen, M.D.

  • Emergency Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1982870150
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50312 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(651) 241-8755
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2009-0051 NM
Emergency Medicine Physician 207P00000X 61335 WI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 50312 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279
Phone (612) 439-1860

Other practice location 1

701 Park Ave South
Hennepin County Medical Center Revenue Management
Minneapolis, MN 55415
Phone (612) 873-3044

Other identifiers 1

IdentifierTypeStateIssuer
19579OtherMNRESIDENT PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120116000077 MN Practitioner - Emergency Medicine 9638222730 Reassigns benefits to 1 organization
I20140226001871 WI Practitioner - Emergency Medicine 9638222730 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Care Consultants PAGroup PAC ID 5496640161, 105 clinicians

Practice addresses (Care Compare)

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

Hospital & facility affiliations

  • Allina United Hospital Hospital, Saint Paul, MN, CCN 240038
  • Western Wisconsin Health Hospital, Baldwin, WI, CCN 521347
  • River Falls Area Hospital Hospital, River Falls, WI, CCN 521349
  • Owatonna Hospital Hospital, Owatonna, MN, CCN 240069

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2009-0051NMMDEmergency Medicine Physician
61335WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baldwin Area Medical Center, Inc. CurrentSince Dec 2, 2013 Accepting new patients
Ecc Addiction & Toxicology Services LLC CurrentSince May 16, 2022 Accepting new patients
Allina Health System Emergency Medicine Current Accepting new patients
Allina Health System CurrentSince Mar 14, 2014 Accepting new patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Jan 1, 2012 Accepting new patients
Baldwin Area Medical Center Inc. CurrentSince Dec 2, 2013 Accepting new patients
Healthfront PC Emergency Medicine Past Accepting new patients
Regina Medical Center Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

1100 Bergslien St
Baldwin, WI 54002
Phone (715) 684-1111

1400 N Acres Rd
Ste 30
Prescott, WI 54021
Phone (651) 437-3121

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Organizations & group practices 9

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1982870150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279",
            "telephone_number": "612-439-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 PARK AVE SOUTH",
            "address_2": "HENNEPIN COUNTY MEDICAL CENTER REVENUE MANAGEMENT",
            "address_purpose": "LOCATION",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "country_code": "US",
            "telephone_number": "612-873-3044",
            "fax_number": "612-630-8242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2009-0051",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "61335",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "50312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT PERMIT",
            "identifier": "19579",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.