Individual provider Active NPI

Lisa Marlene Olson, PA-C

  • Physician Assistant
  • Eugene, OR
National Provider Identifier
1245326651
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01005 Issued in OR
Practice address
330 S Garden Way Ste 390
Eugene, OR 97401-8179
Phone
(541) 683-1796
NPI assigned
Oct 4, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01005 OR Primary

Addresses

Primary practice location

330 S Garden Way Ste 390
Eugene, OR 97401-8179

Mailing address

330 S Garden Way
Ste 390
Eugene, OR 97401-8179
Phone (541) 683-1796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20041203000470 OR Practitioner - Physician Assistant 7416913249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 S Garden Way
Suite 390
Eugene, OR 97401-8179
Phone (541) 683-3325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01005ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Sleep Disorders Center, LLC CurrentSince Aug 2, 2017 Accepting new patients

Locations

330 S Garden Way
Ste 390
Eugene, OR 97401
Phone (541) 683-1796

Interoperability endpoints

  • Direct secure messaging: emeraldsleepdisordercenter.lisaolson@114323.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245326651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY",
            "address_2": "STE 390",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018179",
            "telephone_number": "541-683-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S GARDEN WAY STE 390",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974018179",
            "telephone_number": "541-683-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "LISA",
        "middle_name": "MARLENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.