Individual provider Active NPI

Dustin Olsen

  • Anesthesiologist Assistant
  • Vero Beach, FL
National Provider Identifier
1215825898
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA1068 Issued in FL
Practice address
1000 36TH St
Vero Beach, FL 32960-4862
Phone
(772) 567-4311
NPI assigned
Jun 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA1068 FL Primary

Addresses

Primary practice location

1000 36TH St
Vero Beach, FL 32960-4862

Mailing address

PO Box 4
Roseland, FL 32957-0004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701001213 FL Practitioner - Anesthesiology Assistant 6204349483 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indian River Health Services IncGroup PAC ID 9234130329, 335 clinicians
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

310 SE Veranda Falls Way
Port Saint Lucie, FL 34984-2101
Phone (772) 309-8500

Hospital & facility affiliations

  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
  • CCN 100366 Hospital, CCN 100366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA1068FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lucie Anesthesia Associates, LLC CurrentSince Jun 24, 2025 Accepting new patients
St Lucie Anesthesia Associates LLC Current Accepting new patients
Ams National LLC CurrentSince Sep 1, 2025 Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Jun 24, 2025 Accepting new patients
Indian River Health Services Inc CurrentSince Jul 14, 2025 Accepting new patients
Indian River Health Services Inc CurrentSince Jul 14, 2025 Accepting new patients

Locations

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

10080 SW Innovation Way
Ste 101
Port St Lucie, FL 34987
Phone (561) 358-2445

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

10521 SW Village Center Dr
Ste 104
Port St Lucie, FL 34987
Phone (772) 345-8600

310 SE Veranda Falls Way
Port St Lucie, FL 34984
Phone (561) 800-4111

1190 37th St
Vero Beach, FL 32960
Phone (772) 563-4666

1000 36th St
Vero Beach, FL 32960
Phone (772) 567-1942

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 6

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 2

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1215825898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4",
            "city": "ROSELAND",
            "state": "FL",
            "postal_code": "329570004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "DUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA1068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.