Individual provider Active NPI

Holly Ouillette

  • Gynecology Physician
  • Wesley Chapel, FL
National Provider Identifier
1013262138
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
4301111847 Issued in MI
Practice address
2309 Crestover LN
Wesley Chapel, FL 33544-6789
Phone
(352) 345-4456
Fax
(352) 835-7740
NPI assigned
Jul 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 4301111847 MI Primary

Addresses

Primary practice location

2309 Crestover LN
Wesley Chapel, FL 33544-6789

Mailing address

2309 Crestover LN
Wesley Chapel, FL 33544-6789
Phone (352) 345-4456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180205002926 MI Practitioner - Obstetrics/Gynecology 9234425414
I20231128001039 FL Practitioner - Obstetrics/Gynecology 9234425414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Farhan Siddiqi MD PAGroup PAC ID 4284936113, 14 clinicians

Practice addresses (Care Compare)

11319 Cortez Blvd
Brooksville, FL 34613-5407
Phone (352) 597-0907

Hospital & facility affiliations

  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Farhan Siddiqi, MD PA CurrentSince Nov 1, 2023 Accepting new patients
Farhan Siddiqi, MD PA CurrentSince Nov 1, 2023 Accepting new patients

Locations

2040 Short Ave
Odessa, FL 33556
Phone (727) 372-9922

11319 Cortez Blvd
Spring Hill, FL 34613
Phone (352) 556-2524

2309 Crestover Ln
Wesley Chapel, FL 33544
Phone (727) 807-2476

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1342224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1013262138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 CRESTOVER LN",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446789",
            "telephone_number": "352-345-4456",
            "fax_number": "352-835-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 CRESTOVER LN",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446789",
            "telephone_number": "352-345-4456",
            "fax_number": "352-835-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUILLETTE",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-14",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "4301111847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.