NPIMap

Individual provider Active NPI

Dominick Olivo, DPM

  • Podiatrist
  • Muncy, PA
National Provider Identifier
1023005378
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC007536 Issued in SC
Practice address
255 Route 220 Hwy Ste 205
Muncy, PA 17756-7568
Phone
(570) 308-2564
Fax
(570) 308-2566
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC007536 SC Primary

Addresses

Primary practice location

255 Route 220 Hwy Ste 205
Muncy, PA 17756-7568

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 308-2564

Other identifiers 1

IdentifierTypeStateIssuer
0000390660MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250731001626 PA Practitioner - Podiatry 9335280882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger Clinic 3,432 clinicians
Geisinger-HM Joint Venture LLC 426 clinicians

Practice addresses (Care Compare)

1020 Thompson St
Jersey Shore, PA 17740-1729
Phone (570) 398-3113

255 Route 220 Hwy
Muncy, PA 17756-7569
Phone (570) 308-2600

Hospital & facility affiliations

  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue152
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
151MTMDProfessional Counselor
SC007536SCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 1, 2025 Accepting new patients
Geisinger Clinic Podiatrist CurrentSince Jul 1, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC CurrentSince Jul 1, 2025 Accepting new patients
Geisinger Clinic CurrentSince Jul 1, 2025 Accepting new patients
Geisinger-HM Joint Venture, LLC Current Accepting new patients
Central Montana Medical Facilities, Inc Past Accepting new patients
Central Montana Medical Facilities, Inc. Foot Surgery Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 205
Muncy, PA 17756
Phone (570) 308-2445

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1023005378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-308-2564",
            "fax_number": "570-308-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ROUTE 220 HWY STE 205",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177567568",
            "telephone_number": "570-308-2564",
            "fax_number": "570-308-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVO",
        "first_name": "DOMINICK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "SC007536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000390660",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncy, PA

Sources for this page

Verify at the official NPI Registry.