Individual provider Active NPI

Rachelle Concepcion Olsen, PA-C

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1174755763
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60123 Issued in CA
Practice address
1441 Eastlake Ave Ste 3444
Los Angeles, CA 90089-2996
Phone
(323) 865-3963
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015764 NY
Physician Assistant 363A00000X PA60123 CA Primary

Addresses

Primary practice location

1441 Eastlake Ave Ste 3444
Los Angeles, CA 90089-2996

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 865-3963

Other names 1

  • Rachelle Concepcion Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rachelle.olsen@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180607002706 NY Practitioner - Physician Assistant 2264797539 Reassigns benefits to 1 organization
I20220216000096 CA Practitioner - Physician Assistant 2264797539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1441 Eastlake Ave
Suite 2424
Los Angeles, CA 90089-0112
Phone (323) 442-2582

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

Hospital & facility affiliations

  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Usc Verdugo Hills Hospital Hospital, Glendale, CA, CCN 050124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60123CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jan 1, 2018 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Feb 1, 2022 Accepting new patients
New York University CurrentSince Jan 1, 2018 Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients
Keck Medical Center of Usc Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1441 Eastlake Ave
Los Angeles, CA 90089
Phone (323) 865-3000

1441 Eastlake Ave
Ste 3444
Los Angeles, CA 90089
Phone (323) 865-3000

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

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 3

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1174755763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-865-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVE STE 3444",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900892996",
            "telephone_number": "323-865-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "RACHELLE",
        "middle_name": "CONCEPCION",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015764",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rachelle.olsen@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHELLE",
            "last_name": "CONCEPCION",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.