Individual provider Active NPI

Martha Ann Olson, P.A.

  • Surgical Physician Assistant
  • Leesburg, FL
National Provider Identifier
1144317876
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9103766 Issued in FL
Practice address
701 Medical Plaza Dr
Leesburg, FL 34748-7313
Phone
(352) 326-8115
Fax
(352) 326-5282
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PAT9103766 FL
Surgical Physician Assistant 363AS0400X PA9103766 FL Primary

Addresses

Primary practice location

701 Medical Plaza Dr
Leesburg, FL 34748-7313

Mailing address

10 Clark St
Enterprise, FL 32725-8106
Phone (386) 507-5269

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
I20061103000176 FL Practitioner - Physician Assistant 5597762518 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

600 E Dixie Ave
Leesburg, FL 34748-5925

701 Medical Plaza Dr
Leesburg, FL 34748-7313
Phone (352) 323-4000

Hospital & facility affiliations

  • Premier Care Homecare LLC Home health agency, Leesburg, FL, CCN 108410
  • Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084
  • Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9103766FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince May 11, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 11, 2021 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

701 Medical Plaza Dr
Leesburg, FL 34748
Phone (352) 326-8115

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: molson16454@direct.shands.ufl.edu

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 5

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1144317876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CLARK ST",
            "city": "ENTERPRISE",
            "state": "FL",
            "postal_code": "327258106",
            "telephone_number": "386-507-5269",
            "fax_number": "855-879-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MEDICAL PLAZA DR",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487313",
            "telephone_number": "352-326-8115",
            "fax_number": "352-326-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MARTHA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PAT9103766",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9103766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.