Mallery Olsen, MD
Mallery Olsen, MD is a Pediatric Hematology & Oncology Physician in Minneapolis, MN, registered under NPI 1649664871. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 2450 RIVERSIDE AVE, Minneapolis, MN 55454. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 80064 | MN | Pediatric Hematology & Oncology Physician primary |
| 80064 | MN | General Practice Physician |
This provider holds licence 80064 issued in MN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Hematology/oncology
- PAC ID
- 4688984420
Enrolled in Medicare 2 times, across 2 states:
| State | Enrollment ID | Provider type |
|---|---|---|
| Arizona | I20220804003344 | Practitioner - Hematology/oncology |
| Minnesota | I20250626004262 | Practitioner - Hematology/oncology |
Medicare enrolment is recorded as approved under the provider type Practitioner - Hematology/oncology. There are 2 separate enrolment records across 2 states (AZ, MN). Multiple enrolments usually mean the provider bills Medicare from more than one practice location, or has kept an earlier enrolment after moving. Each record carries its own enrolment ID, listed above. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Pediatric Hematology-Oncology covers
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. NUCC Health Care Provider Taxonomy, code 2080P0207X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2080P0207X | Pediatric Hematology & Oncology Physician Pediatric Hematology-Oncology | 80064 | MN | primary |
| 208D00000X | General Practice Physician | 80064 | MN |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1649664871 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 25, 2015 |
| Last updated | Oct 24, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
2450 RIVERSIDE AVE Minneapolis, MN 55454 (612) 365-8100 |
| Mailing address |
2450 RIVERSIDE AVE # 8951 Minneapolis, MN 55454 |
| Other identifiers |
163982
· Medicaid (AZ) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 4 | 9 | 6 | 6 | 4 | 8 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 8 | 9 | 3 | 6 | 8 | 8 | 5 |
Sum = 79 · next multiple of 10 = 80 · check digit = 1 · actual last digit = 1
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.