Individual provider Active NPI

Sybil Ling Olmo, NP

  • Family Nurse Practitioner
  • Ridgewood, NY
National Provider Identifier
1245914209
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345574-01 Issued in NY
Practice address
6433 Madison St
Ridgewood, NY 11385-4629
Phone
(718) 406-1393
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 711875 NY
Family Nurse Practitioner 363LF0000X F345574-01 NY Primary

Addresses

Primary practice location

6433 Madison St
Ridgewood, NY 11385-4629

Mailing address

6433 Madison St FL 1
Ridgewood, NY 11385-4629
Phone (718) 406-1393

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231211001142 NY Practitioner - Nurse Practitioner 3274982640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

1283 York Ave
New York, NY 10065-5662
Phone (646) 697-0939

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
711875NYMDGastroenterology Registered Nurse
F345574-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Jan 10, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Jan 10, 2024 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

525 E 68th St
Rm J314
New York, NY 10065
Phone (212) 746-4158

525 E 68th St
#J314
New York, NY 10065
Phone (212) 746-4158

156 William St
New York, NY 10038
Phone (646) 962-4679

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: slo9006@direct.nyp.org

Organizations & group practices 3

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 5

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1245914209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 MADISON ST FL 1",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854629",
            "telephone_number": "718-406-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6433 MADISON ST",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113854629",
            "telephone_number": "718-406-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMO",
        "first_name": "SYBIL",
        "middle_name": "LING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "NY",
            "license": "711875",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345574-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

Verify at the official NPI Registry.