Individual provider Active NPI

Olivia Victoriano

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Atlanta, GA
National Provider Identifier
1174109631
Registry record updated Jun 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Emergency Medicine) PhysicianTaxonomy code 207PH0002X
License
16893 Issued in GA
Practice address
1365 Clifton Rd NE FL Clinica4
Atlanta, GA 30322-5896
Phone
(404) 778-6448
NPI assigned
Mar 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hospice and Palliative Medicine (Emergency Medicine) Physician 207PH0002X 16893 GA Primary

Addresses

Primary practice location

1365 Clifton Rd NE FL Clinica4
Atlanta, GA 30322-5896

Mailing address

1365 Clifton Rd NE FL Clinica4
Atlanta, GA 30322-1013
Phone (404) 778-6448

Other practice location 1

31700 Temecula Pkwy Ste 1
Temecula, CA 92592-5896
Phone (951) 331-2535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20250916001281 GA Practitioner - Hospice/Palliative Care 7416491048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative Care
Education
Florida State University College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16893GAMDHospice and Palliative Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc CurrentSince Aug 26, 2025 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

1365 Clifton Rd NE
#4
Atlanta, GA 30322
Phone (404) 778-6448

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": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750982400000",
    "number": "1174109631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE FL CLINICA4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE FL CLINICA4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303225896",
            "telephone_number": "404-778-6448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31700 Temecula Pkwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925925896",
            "country_code": "US",
            "telephone_number": "951-331-2535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICTORIANO",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "16893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.