Alicia Leandra Olowu, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

298392 Issued in NY

Practice address

707 E Main St
Middletown, NY 10940-2650

Phone

(845) 333-7575

Fax

(845) 333-7139

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Alicia Leandra Bourne Other name

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Garnet Health Urgent Care PCGroup PAC ID 5395009765, 21 clinicians

Garnet Health Doctors PCGroup PAC ID 8628293545, 165 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willcare Chha (Newburgh) Home health agency, Newburgh, NY, CCN 337408
• Archcare at Home Home health agency, Valhalla, NY, CCN 337140
• Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

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

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.

• Garnet Health Doctors PC

  • General Practice Physician
  • Middletown, NY
  • NPI 1093138851
  Medicare reassignment Care Compare group NPD
• Garnet Health Urgent Care PC

  • Urgent Care Clinic/Center
  • Middletown, NY
  • NPI 1316446651
  Medicare reassignment Care Compare group
• Garnet Health Doctors PC

  • General Practice Physician
  • Harris, NY
  • NPI 1164845699
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Garnet Health Medical Center

  • General Acute Care Hospital
  • Middletown, NY
  • NPI 1609875772
  Care Compare affiliation
• Litson Certified Care, Inc.

  • Home Health Agency
  • Newburgh, NY
  • NPI 1609926195
  Care Compare affiliation
• The Dominican Sisters Family Health Service Inc

  • Home Health Agency
  • Valhalla, NY
  • NPI 1821184839
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1164873113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-7139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 State Route 17M",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NY",
            "postal_code": "109504169",
            "country_code": "US",
            "telephone_number": "845-333-7830",
            "fax_number": "845-333-7475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLOWU",
        "first_name": "ALICIA",
        "middle_name": "LEANDRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "298392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aolowu33219@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "BOURNE",
            "middle_name": "LEANDRA",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Okeefe, RPH
• Dianette Marie Oliva, LMHC
• Tierra Catherine Oliver, FNP-BC
• Karly Alexandra Olivieri, CRNA
• Kathleen Olley, RN
• Samantha Olson, LMHC
• Mihai Olteanu, M.D.
• Joseph Omoregie, LPN
• Oluwafemi A Omosebi
• Regina Adetoro Omosebi, MA PSYCHOLOGIST

• Family Medicine Physician in Middletown, NY
• Providers in Middletown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.