Individual provider Active NPI

Marilyn Kristine Olita, NP

  • Family Nurse Practitioner
  • Bay Shore, NY
National Provider Identifier
1154211449
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357321 Issued in NY
Practice address
440 E Main St
Bay Shore, NY 11706-8501
Phone
(516) 382-0165
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357321 NY Primary

Addresses

Primary practice location

440 E Main St
Bay Shore, NY 11706-8501

Mailing address

440 E Main St
Bay Shore, NY 11706-8501

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
I20251122001346 NY Practitioner - Nurse Practitioner 4880186238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
357321NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Nov 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 1, 2025 Accepting new patients

Locations

440 E Main St
Bay Shore, NY 11706
Phone (631) 414-2023

440 E Main St
Ste A
Bay Shore, NY 11706
Phone (520) 414-8000

300 Community Dr
Plandome, NY 11030

Networks

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

Interoperability endpoints

  • Direct secure messaging: marilynolita@nslijmedgr.allscriptsdirect.net

Organizations & group practices 2

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1154211449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068501",
            "telephone_number": "516-382-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLITA",
        "first_name": "MARILYN",
        "middle_name": "KRISTINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.