Individual provider Active NPI

Olivia Mauricio, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1285358804
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
405220 Issued in NY
Practice address
245 5TH Ave FL 3
New York, NY 10016-8728
Phone
(855) 444-7258
Fax
(877) 261-8495
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405220 NY Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN2339766 MA

Addresses

Primary practice location

245 5TH Ave FL 3
New York, NY 10016-8728

Mailing address

245 5TH Ave FL 3
New York, NY 10016-8728
Phone (855) 444-7258

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
I20250314002755 NY Practitioner - Nurse Practitioner 6800318247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Nurse Practitioner PCGroup PAC ID 6901221795, 45 clinicians

Practice addresses (Care Compare)

191 Orchard St
Apt 4D
New York, NY 10002-1424
Phone (718) 534-0689

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2339766MAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Nurse Practitioner P.C Psychiatric/Mental Health CurrentSince Dec 9, 2024 Accepting new patients

Locations

245 5th Ave
Fl 3
New York, NY 10016
Phone (212) 302-4399

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.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1285358804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "855-444-7258",
            "fax_number": "877-261-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "855-444-7258",
            "fax_number": "877-261-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "OLIVIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405220",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2339766",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.