Perry J Olson, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

364544473 Issued in MI

Practice address

20400 W Warren Ave
Detroit, MI 48228-3242

Phone

(313) 271-0500

Fax

(313) 271-9319

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

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.

• Daisy Mae Family Medicine PLLC

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1043971922
  Medicare reassignment

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1104847847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23161 BRITNER CT",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254707",
            "telephone_number": "248-988-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20400 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283242",
            "telephone_number": "313-271-0500",
            "fax_number": "313-271-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "PERRY",
        "middle_name": "J",
        "credential": "P.A.-C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "364544473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00219893",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Renee Olsen
• Karen Lynn Olsen, NP
• Adrian Olson, DO
• Holly Rose Olson, MS
• Joshua Olson
• Adam Olszewski
• Deborah Suzanne Olszewski, CNP
• Babawale O Oluborode, MD
• Wanda Olugbala, LMSW
• Ritta Olugbile, LMSW

• Medical Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.