Individual provider Active NPI

Bruce A Olson, DPM

  • Podiatrist
  • Oxnard, CA
National Provider Identifier
1225020472
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E1206 Issued in CA
Practice address
2035 Saviers Rd
Ste 5
Oxnard, CA 93033-3650
Phone
(805) 486-8710
Fax
(805) 486-2856
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E1206 CA Primary

Addresses

Primary practice location

2035 Saviers Rd
Ste 5
Oxnard, CA 93033-3650

Mailing address

2035 Saviers Rd
Ste 5
Oxnard, CA 93033-3650
Phone (805) 486-8710

Other identifiers 3

IdentifierTypeStateIssuer
0883610001OtherCACIGNA MEDICARE
000E120607MedicaidCA
P00194968OtherRAILROAD MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101213000782 CA Practitioner - Podiatry 8022083096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E1206CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1225020472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 SAVIERS RD",
            "address_2": "STE 5",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333650",
            "telephone_number": "805-486-8710",
            "fax_number": "805-486-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SAVIERS RD",
            "address_2": "STE 5",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930333650",
            "telephone_number": "805-486-8710",
            "fax_number": "805-486-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "BRUCE",
        "middle_name": "A",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "0883610001",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E120607",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00194968",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.