Physician Compare National (NPI:1942697131)

HEALTHCARE PROVIDER: THOMAS HAROLDSON MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1942697131
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648563817
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160726000761
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAROLDSON
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SPORTS MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SPORTS MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	FAMILY HEALTHSERVICES MINNESOTA, P.A. DBA ENTIRA FAMILY CLINICS
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1355369018
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	66
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3550 LABORE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 7
	Group Practice or individual's line 2 address
City	VADNAIS HEIGHTS
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	551105113
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6517660520
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	240063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPH'S HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y