NPIMap

Individual provider Active NPI

Olivia Cathleen Anderson, PA-C

  • Surgical Physician Assistant
  • Reno, NV
National Provider Identifier
1184473381
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
10791 Double R Blvd
Reno, NV 89521-8956
Phone
(775) 323-6100
Fax
(775) 323-6118
NPI assigned
May 18, 2024
Last updated
May 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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 NU
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

10791 Double R Blvd
Reno, NV 89521-8956

Mailing address

10791 Double R Blvd
Reno, NV 89521-8956
Phone (775) 323-6100

Other practice location 1

1470 Medical Pkwy Ste 240
Carson City, NV 89703-4647
Phone (775) 323-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014002917 NV Practitioner - Physician Assistant 5597297655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michael H Song MD LTDGroup PAC ID 5597765016, 5 clinicians
Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

1470 Medical Pkwy
Suite 240
Carson City, NV 89703-4647
Phone (775) 323-6100

1600 Medical Pkwy
Carson City, NV 89703-4625
Phone (775) 445-8000

2170 B S Ave
South Lake Tahoe, CA 96150-7026
Phone (530) 539-6620

935 Mica Dr
Suite 13
Carson City, NV 89705-7181
Phone (775) 783-3065

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michael H Song MD LTD CurrentSince Sep 1, 2024 Accepting new patients

Locations

1470 Medical Pkwy
Ste 240
Carson City, NV 89703
Phone (775) 323-6100

10791 Double R Blvd
Reno, NV 89521
Phone (775) 284-2020

343 Elm St
Ste 202
Reno, NV 89503
Phone (775) 323-6100

Interoperability endpoints

  • Direct secure messaging: oanderson722088@direct.med.utah.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1184473381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10791 DOUBLE R BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218956",
            "telephone_number": "775-323-6100",
            "fax_number": "775-323-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10791 DOUBLE R BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895218956",
            "telephone_number": "775-323-6100",
            "fax_number": "775-323-6118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 Medical Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Carson City",
            "state": "NV",
            "postal_code": "897034647",
            "country_code": "US",
            "telephone_number": "775-323-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "OLIVIA",
        "middle_name": "CATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.