Individual provider Active NPI

Robert Stanley Olivieri, DC

  • Orthopedic Chiropractor
  • Rio Grande, NJ
National Provider Identifier
1043224090
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
MC03186 Issued in NJ
Practice address
1501 Route 47
Rio Grande, NJ 08242-1401
Phone
(609) 886-8585
Fax
(609) 886-8540
NPI assigned
Jul 27, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X MC03186 NJ
Orthopedic Chiropractor 111NX0800X MC03186 NJ Primary

Addresses

Primary practice location

1501 Route 47
Rio Grande, NJ 08242-1401

Mailing address

1501 Route 47
Rio Grande, NJ 08242-1401
Phone (609) 886-8585

Other identifiers 1

IdentifierTypeStateIssuer
0099307000OtherNJ10-DIGIT HMO ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040128000422 NJ Practitioner - Chiropractic 9234032301 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC03186NJMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Health Marlton LLC CurrentSince May 5, 2022 Accepting new patients
Active Health Marmora LLC CurrentSince May 6, 2022 Accepting new patients
Regenerative Medicine of South Jersey LLC CurrentSince Sep 7, 2018 Accepting new patients
Active Health Northfield LLC CurrentSince Jun 8, 2022 Accepting new patients

Locations

16 Roosevelt Blvd
Marmora, NJ 08223
Phone (609) 390-0292

1317 Route 73
Ste 101
Mount Laurel, NJ 08054
Phone (609) 886-8039

1612 Tilton Rd
Northfield, NJ 08225
Phone (609) 277-2477

1501 Route 47
Rio Grande, NJ 08242
Phone (609) 224-1576

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043224090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ROUTE 47",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421401",
            "telephone_number": "609-886-8585",
            "fax_number": "609-886-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ROUTE 47",
            "city": "RIO GRANDE",
            "state": "NJ",
            "postal_code": "082421401",
            "telephone_number": "609-886-8585",
            "fax_number": "609-886-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVIERI",
        "first_name": "ROBERT",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "NJ",
            "license": "MC03186",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "NJ",
            "license": "MC03186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "10-DIGIT HMO ID",
            "identifier": "0099307000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.