NPIMap

Individual provider Active NPI

Maria M Olmeda, M.D.

  • Gastroenterology Physician
  • Orange Park, FL
National Provider Identifier
1316032923
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME122386 Issued in FL
Practice address
1542 Kingsley Ave
Suite 140
Orange Park, FL 32073-4586
Phone
(904) 579-3189
Fax
(904) 458-4054
NPI assigned
Oct 3, 2006
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 200401107 NC
Gastroenterology Physician 207RG0100X 2001-275 NM
Gastroenterology Physician 207RG0100X ME122386 FL Primary

Addresses

Primary practice location

1542 Kingsley Ave
Suite 140
Orange Park, FL 32073-4586

Mailing address

1542 Kingsley Ave
Suite 140
Orange Park, FL 32073-4586
Phone (904) 579-3189

Other identifiers 5

IdentifierTypeStateIssuer
000G262MedicaidNM
1374HOtherNCBLUE CROSS BLUE SHEILD
839467OtherAZAHCCCS
014961100MedicaidFL
891374HMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109000166 FL Practitioner - Gastroenterology 5395731772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Ponce School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

2151 Riverside Ave
Jacksonville, FL 32204-4416
Phone (904) 388-8686

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy17
Upper gastrointestinal (GI) endoscopy for acid reflux19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME122386FLMDGastroenterology Physician
200401107NCMDGastroenterology Physician
2001-275NMMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants Gastroenterology CurrentSince Sep 22, 2020 Accepting new patients
American Physicians Foundation Corporation CurrentSince Aug 6, 2018 Accepting new patients
Advanced Gastroenterology Associates Gastroenterology Past Accepting new patients
Western Carolina Endoscopy Center, LLC PastSince Jan 1, 2009 Accepting new patients
Four Corners Gastroenterology Consultants PC Gastroenterology Past Accepting new patients
Western Carolina Digestive Consultants PA Gastroenterology Past Accepting new patients
Physicians Group Services PA Past Accepting new patients

Locations

2151 Riverside Ave
Jacksonville, FL 32204
Phone (904) 381-8900

1542 Kingsley Ave
Ste 140
Orange Park, FL 32073
Phone (904) 278-3820

Interoperability endpoints

  • FHIR API: https://35e809af-55fd-4464-b97b-98cb80ebf600.gastro.prod.fhir.ema-api.com/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDJDBA
  • Direct secure messaging: molmeda@amerpf.curemd.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1316032923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE",
            "address_2": "SUITE 140",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734586",
            "telephone_number": "904-579-3189",
            "fax_number": "904-458-4054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE",
            "address_2": "SUITE 140",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734586",
            "telephone_number": "904-579-3189",
            "fax_number": "904-458-4054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMEDA",
        "first_name": "MARIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "200401107",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "2001-275",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME122386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000G262",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "1374H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "839467",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014961100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891374H",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.