Individual provider Active NPI

Gerardo Andres Fernandez Olivero, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1134500093
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
33789 Issued in WV
Practice address
1901 1St Ave
New York, NY 10029-7404
Phone
(212) 423-6262
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 33789 WV Primary
Emergency Medicine Physician 207P00000X 139063 FL

Addresses

Primary practice location

1901 1St Ave
New York, NY 10029-7404

Mailing address

777 N Orange Ave Apt 500
Orlando, FL 32801-1183
Phone (347) 476-2938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190710000686 FL Practitioner - Emergency Medicine 8123353489 Reassigns benefits to 5 organizations
I20250129001802 WV Practitioner - Emergency Medicine 8123353489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgewood Emergency Group, LLCGroup PAC ID 6305199597, 43 clinicians
Lake Wales Emergency Physicians, LLCGroup PAC ID 8022270461, 36 clinicians

Practice addresses (Care Compare)

17430 Bali Blvd
Winter Garden, FL 34787-9507
Phone (863) 422-5582

410 S 11TH St
Lake Wales, FL 33853-4203
Phone (863) 676-1433

Hospital & facility affiliations

  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137
  • Adventhealth Lake Wales Hospital, Lake Wales, FL, CCN 100099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
139063FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Jan 2, 2024 Accepting new patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Jan 2, 2024 Accepting new patients
Paragon Emergency Services LLC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Tampa Bay Emergency Physicians-Heartland LLC Emergency Medicine CurrentSince Oct 31, 2023 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Lake Wales Emergency Physicians, LLC Emergency Medicine CurrentSince Dec 17, 2023 Accepting new patients

Locations

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

410 S 11th St
Lake Wales, FL 33853
Phone (863) 676-1433

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

17430 Bali Blvd
Winter Garden, FL 34787
Phone (863) 419-2496

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Organizations & group practices 7

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 2

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": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1134500093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N ORANGE AVE APT 500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328011183",
            "telephone_number": "347-476-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100297404",
            "telephone_number": "212-423-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ OLIVERO",
        "first_name": "GERARDO",
        "middle_name": "ANDRES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "33789",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "139063",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.