Active NPI
Benjamin A Olson, PA-C
- Physician Assistant
- Jackson, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601011216
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-4800
- NPI assigned
- Sep 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601011216 | MI | Primary |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Medical University of South Carolina College of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
205 N E Ave
Jackson, MI 49201-1753
7845 Spring Arbor Rd
Spring Arbor, MI 49283-9785
Phone (517) 205-2580
Hospital & facility affiliations
- Henry Ford Allegiance Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601011216 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Physician Assistant | Current | Accepting new patients |
| W.a. Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Physician Assistant | Past | Accepting new patients |
| Harmony Medical Group PLLC | Past | Accepting new patients |
Locations
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
1201 E Michigan Ave
Ste 300
Jackson, MI 49201
Phone (517) 205-1431
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000
7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580
Interoperability endpoints
- bolson828280@direct.hfhs.org
Organizations & group practices 5
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.
-
- Nurse Practitioner
- Jackson, MI
- NPI 1629000708
-
- Nurse Practitioner
- Jackson, MI
- NPI 1366988347
-
- Physician Assistant
- Jackson, MI
- NPI 1538606348
-
- Internal Medicine Physician
- South Lyon, MI
- NPI 1689485534
-
- Emergency Medicine Physician
- Jackson, MI
- NPI 1265487722
Physician Assistant
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MI
- NPI 1053403402
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672185600000",
"number": "1992428882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450",
"telephone_number": "313-874-4806",
"fax_number": "313-876-1305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N EAST AVE",
"city": "JACKSON",
"state": "MI",
"postal_code": "492011753",
"telephone_number": "517-205-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "BENJAMIN",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-26",
"last_updated": "2022-12-28",
"certification_date": "2022-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601011216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.