Individual provider Active NPI

Olha K Quintero

  • Surgical Physician Assistant
  • Lodi, CA
National Provider Identifier
1194368787
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
59408 Issued in CA
Practice address
815 S Fairmont Ave
Lodi, CA 95240-5116
Phone
(209) 333-1884
NPI assigned
Oct 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 59408 CA
Surgical Physician Assistant 363AS0400X 59408 CA Primary

Addresses

Primary practice location

815 S Fairmont Ave
Lodi, CA 95240-5116

Mailing address

815 S Fairmont Ave
Lodi, CA 95240-5116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220303002817 CA Practitioner - Physician Assistant 1456745629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health Physicians NetworkGroup PAC ID 3274580972, 628 clinicians

Practice addresses (Care Compare)

1031 S Fairmont Ave
Lodi, CA 95240-5112
Phone (209) 334-8580

729 Pauline Court
Sonora, CA 95370
Phone (209) 588-8068

815 S Fairmont Ave
Lodi, CA 95240-5116
Phone (209) 333-1884

Hospital & facility affiliations

  • Adventist Health Lodi Memorial Hospital, Lodi, CA, CCN 050336

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59408CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Apr 1, 2022 Accepting new patients
Adventist Health Physicians Network CurrentSince Apr 1, 2022 Accepting new patients

Locations

815 S Fairmont Ave
Lodi, CA 95240
Phone (209) 333-1884

1235 W Vine St
Ste 22
Lodi, CA 95240
Phone (209) 334-8520

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 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": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1194368787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405116",
            "telephone_number": "209-333-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "OLHA",
        "middle_name": "K",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "59408",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "59408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.