Individual provider Active NPI

Patricia Oliva, PA-C

  • Medical Physician Assistant
  • Kissimmee, FL
National Provider Identifier
1053870022
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9111857 Issued in FL
Practice address
1162 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone
(407) 343-9006
Fax
(407) 343-0999
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9111857 FL Primary

Addresses

Primary practice location

1162 Cypress Glen Cir
Kissimmee, FL 34741-7560

Mailing address

904 Tomahawk TRL
Brandon, FL 33511-8092
Phone (813) 245-7284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190625003955 FL Practitioner - Physician Assistant 6709110729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida ENT Adult and Pediatric PAGroup PAC ID 3971532763, 7 clinicians

Practice addresses (Care Compare)

1162 Cypress Glen Cir
Kissimmee, FL 34741-7560
Phone (407) 343-9006

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida ENT Adult & Pediatrics, PA Medical Current Accepting new patients

Locations

1162 Cypress Glen Cir
Kissimmee, FL 34741
Phone (407) 343-9006

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 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1053870022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 TOMAHAWK TRL",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118092",
            "telephone_number": "813-245-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1162 CYPRESS GLEN CIR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347417560",
            "telephone_number": "407-343-9006",
            "fax_number": "407-343-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "PATRICIA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9111857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.