Individual provider Active NPI

Arcadio J Oliva, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Jacksonville, FL
National Provider Identifier
1275512295
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME53804 Issued in FL
Practice address
800 Prudential Dr
Jacksonville, FL 32207-8202
Phone
(912) 261-2669
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 0101041969 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME53804 FL Primary

Addresses

Primary practice location

800 Prudential Dr
Jacksonville, FL 32207-8202

Mailing address

PO Box 537046
Atlanta, GA 30353-7046
Phone (912) 261-2669

Other practice location 1

40100 Highway 27
Davenport, FL 33837-5906
Phone (863) 419-2496

Other identifiers 1

IdentifierTypeStateIssuer
262599700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060418000506 FL Practitioner - Pathology 7719996883 Reassigns benefits to 1 organization
I20250203003616 GA Practitioner - Pathology 7719996883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Pathology Associates PCGroup PAC ID 5890781371, shared by 2 NPIs, 45 clinicians

Practice addresses (Care Compare)

203 Indigo Dr
Brunswick, GA 31525-6865
Phone 91226126691205

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (912) 261-2669

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME53804FLMDAnatomic Pathology & Clinical Pathology Physician
0101041969VAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Nov 1, 2024 Accepting new patients
Southeastern Pathology Associates PC Anatomic Pathology & Clinical Pathology CurrentSince Feb 7, 2018 Accepting new patients

Locations

1250 S 18th St
Fernandina Beach, FL 32034
Phone (904) 202-2087

801 Oak St
Green Cv Spgs, FL 32043
Phone (904) 215-7015

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

14550 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 202-5010

1350 13th Ave S
Jax Bch, FL 32250
Phone (904) 247-2900

203 Indigo Dr
Brunswick, GA 31525
Phone (912) 279-1900

898 College St
Monticello, GA 31064
Phone (706) 468-0988

2810 N Oak St
Valdosta, GA 31602
Phone (229) 259-0019

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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 3

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1275512295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537046",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303537046",
            "telephone_number": "912-261-2669",
            "fax_number": "912-261-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "912-261-2669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40100 Highway 27",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "FL",
            "postal_code": "338375906",
            "country_code": "US",
            "telephone_number": "863-419-2496",
            "fax_number": "863-419-2481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVA",
        "first_name": "ARCADIO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VA",
            "license": "0101041969",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME53804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262599700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.