Individual provider Active NPI

Olga A Pawliczak, NP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1033627112
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F342449-1 Issued in NY
Practice address
21 W End Ave Apt 2111
New York, NY 10023-7979
Phone
(352) 217-9910
NPI assigned
Jan 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F342449-1 NY Primary

Addresses

Primary practice location

21 W End Ave Apt 2111
New York, NY 10023-7979

Mailing address

21 W End Ave Apt 2111
New York, NY 10023-7979
Phone (352) 217-9910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180406000300 NY Practitioner - Nurse Practitioner 6507129426 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F342449-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Trustees of Columbia University in the City of New York Family CurrentSince Feb 26, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jun 1, 2018 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

161 Fort Washington Ave
#8
New York, NY 10032
Phone (646) 317-6041

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1033627112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W END AVE APT 2111",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237979",
            "telephone_number": "352-217-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W END AVE APT 2111",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237979",
            "telephone_number": "352-217-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLICZAK",
        "first_name": "OLGA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F342449-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.