Individual provider Active NPI

Kaitlyn Oliveri, PA-C

  • Physician Assistant
  • Oceanside, NY
National Provider Identifier
1003382383
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 One Healthy Way
Oceanside, NY 11572-1551
Phone
(516) 632-3935
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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 Primary

Addresses

Primary practice location

1 One Healthy Way
Oceanside, NY 11572-1551

Mailing address

1 One Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023068NYMDOccupational Therapist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1003382383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ONE HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ONE HEALTHY WAY",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721551",
            "telephone_number": "516-632-3935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERI",
        "first_name": "KAITLYN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.