Active NPI
Christian Gardy Olivier
- Registered Nurse
- Central Islip, NY
National Provider Identifier
1235896549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 897959-01
- Practice address
- 772 Ferndale Blvd
Central Islip, NY 11722-4812 - Phone
- (631) 882-1047
- NPI assigned
- Nov 22, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 897959-01 | NY | Primary |
Addresses
Primary practice location
772 Ferndale Blvd
Central Islip, NY 11722-4812
Mailing address
772 Ferndale Blvd
Central Islip, NY 11722-4812
Phone (631) 882-1047
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 920472205 | Other | NY | DRIVERS LICENSE |
| 920472205 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 897959-01 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optimal Life LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Nursing Care Agency
- Bohemia, NY
- NPI 1447080270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1235896549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "772 FERNDALE BLVD",
"city": "CENTRAL ISLIP",
"state": "NY",
"postal_code": "117224812",
"telephone_number": "631-882-1047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "772 FERNDALE BLVD",
"city": "CENTRAL ISLIP",
"state": "NY",
"postal_code": "117224812",
"telephone_number": "631-882-1047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVIER",
"first_name": "CHRISTIAN",
"middle_name": "GARDY",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-22",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "897959-01",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "920472205",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "920472205",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Central Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.