Individual provider Active NPI

John Wiliam Olbeter, PA-C

  • Physician Assistant
  • Farmingdale, NY
National Provider Identifier
1124493259
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019359 Issued in NY
Practice address
11 1St Ave
Farmingdale, NY 11735-5702
Phone
(516) 695-5994
NPI assigned
Dec 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019359 NY Primary

Addresses

Primary practice location

11 1St Ave
Farmingdale, NY 11735-5702

Mailing address

11 1St Ave
Farmingdale, NY 11735-5702
Phone (516) 695-5994

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
I20161003001163 NY Practitioner - Physician Assistant 0941597108 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019359NYMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital United States Catholic Conference CurrentSince Sep 17, 2016 Accepting new patients
St. Francis Hospital CurrentSince Sep 17, 2016 Accepting new patients
Good Samaritan Hospital Medical CurrentSince Sep 17, 2016 Accepting new patients
Good Samaritan Hospital CurrentSince Sep 17, 2016 Accepting new patients

Locations

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 8

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": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1124493259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 1ST AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355702",
            "telephone_number": "516-695-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 1ST AVE",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117355702",
            "telephone_number": "516-695-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLBETER",
        "first_name": "JOHN",
        "middle_name": "WILIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.