Shital Oli, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

101 Dates Drive, Internal Medicine Residency, Cayuga
Ithaca, NY 14850

Phone

(607) 277-2170

NPI assigned

May 11, 2020

Reactivated

Jan 12, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: soli185017@direct-guthrie.org

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1194347351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DATES DRIVE, INTERNAL MEDICINE RESIDENCY, CAYUGA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "646-204-5218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DATES DRIVE, INTERNAL MEDICINE RESIDENCY, CAYUGA",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-277-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLI",
        "first_name": "SHITAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "deactivation_date": "2022-01-11",
        "reactivation_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Hill Operating Co LLC
• OB-GYN Associates of Ithaca, LLP
• Richard D Oberly, D.M.D.
• Emily Olander, LMSW
• Diane Olden
• Candice M Oliver, D.O.
• Jane Olsefski, PA
• Ariana Olsen
• Amanda Olson
• Melissa Clare Oltz, O.D.

• Student in an Organized Health Care Education/Training Program in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.