Individual provider Active NPI

Olivia Nassoiy

  • Certified Registered Nurse Anesthetist
  • Santa Monica, CA
National Provider Identifier
1114523305
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95001451 Issued in CA
Practice address
1717 Robson Ave
Santa Monica, CA 90405-5917
Phone
(847) 912-2664
NPI assigned
Dec 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 95001451 CA Primary

Addresses

Primary practice location

1717 Robson Ave
Santa Monica, CA 90405-5917

Mailing address

1717 Robson Ave
Santa Monica, CA 90405-5917
Phone (847) 912-2664

Other names 1

  • Olivia Marciniak Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221101002728 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204203458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 343-7044

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6925NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pender Memorial Hospital, Incorporated CurrentSince Jul 13, 2024 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Single Specialty CurrentSince Oct 24, 2022 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Single Specialty CurrentSince Oct 24, 2022 Accepting new patients
Pender Memorial Hospital Incorporated Single Specialty CurrentSince Jul 13, 2024 Accepting new patients

Locations

507 E Fremont St
Burgaw, NC 28425
Phone (910) 259-5451

105 Scotts Hill Medical Dr
Wilmington, NC 28411
Phone (910) 686-2840

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

Organizations & group practices 4

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 1

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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1114523305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 ROBSON AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055917",
            "telephone_number": "847-912-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 ROBSON AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055917",
            "telephone_number": "847-912-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSOIY",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MARCINIAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.