Ivan Y Olesh

Primary specialty

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

Practice address

3399 Warners Rd
Camillus, NY 13031-9649

Phone

(315) 460-5872

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical PCGroup PAC ID 4688855844, 388 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iolesh2389113@direct.trinity-health.org

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.

• St Josephs Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1942501747
  Medicare reassignment Care Compare group
• United Health Services Hospitals, Inc.

  • Multi-Specialty Clinic/Center
  • Johnson City, NY
  • NPI 1962463851
  Medicare reassignment NPD
• United Medical Associates PC

  • Clinic/Center
  • Binghamton, NY
  • NPI 1013972801
  Medicare reassignment NPD
• North Medical PC

  • Family Medicine Physician
  • Liverpool, NY
  • NPI 1972563070
  NPD
• United Medical Associates, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Binghamton, NY
  • NPI 1629252556
  NPD

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

• St Josephs Hospital Health Center

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1508815333
  Care Compare affiliation

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1215565668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 WARNERS RD",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130319649",
            "telephone_number": "315-460-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 WARNERS RD",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130319649",
            "telephone_number": "315-460-5872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4417 Vestal Pkwy E",
            "address_purpose": "LOCATION",
            "city": "Vestal",
            "state": "NY",
            "postal_code": "13850",
            "country_code": "US",
            "telephone_number": "607-763-6580",
            "fax_number": "607-763-6782",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Harrison St, Ste 250",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "NY",
            "postal_code": "13790",
            "country_code": "US",
            "telephone_number": "607-763-6580",
            "fax_number": "607-763-6782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLESH",
        "first_name": "IVAN",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025978",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie North, PA-C
• Emma Lee Norton
• Nurturing Connections Marriage and Family Therapy, PLLC
• Chelsea O'Connor, NP
• Kathleen M O'Connor, NP
• Kimberly Lynn Olrich, FNP
• Mark A. Paciorek, DDS, MS, PC
• Stefanie Pack-Campbell, LPN
• Jessica Lynn Pagan, MS, LMHC, NCC
• David Thurber Page, MD

• Student in an Organized Health Care Education/Training Program in Camillus, NY
• Providers in Camillus, 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 Dec 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.