Individual provider Active NPI

Jessica Anne Olsen, MD

  • Pain Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1316177223
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
124131 Issued in FL
Practice address
777 37TH St Ste C103
Vero Beach, FL 32960-7301
Phone
(772) 971-6096
Fax
(949) 561-4251
NPI assigned
Jul 27, 2009
Last updated
Apr 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 124131 FL
Surgery Physician 208600000X 241768 MA
Pain Medicine Physician 208VP0000X 124131 FL Primary

Addresses

Primary practice location

777 37TH St Ste C103
Vero Beach, FL 32960-7301

Mailing address

777 37TH St Ste C103
Vero Beach, FL 32960-7301
Phone (772) 971-6096

Other practice location 1

820 37th Pl
Vero Beach, FL 32960-6562
Phone (772) 569-9788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150728006283 FL Practitioner - Pain ManagementPractitioner - Psychiatry 9133433675 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Psychiatry
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Mental Health Association in Indian River County IncGroup PAC ID 2163652181, 11 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

2502 Quincy Ave
Fort Pierce, FL 34947-4766
Phone (561) 352-7413

820 37TH PL
Vero Beach, FL 32960-6562
Phone (772) 569-9788

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124131FLMDPsychiatry Physician
241768MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Intervention Associates LLC CurrentSince Feb 19, 2021 Accepting new patients

Locations

2502 Quincy Ave
Fort Pierce, FL 34947
Phone (561) 352-7413

777 37th St
Ste C103
Vero Beach, FL 32960
Phone (561) 567-7639

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, 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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1316177223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 37TH ST STE C103",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607301",
            "telephone_number": "772-971-6096",
            "fax_number": "949-561-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 37TH ST STE C103",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607301",
            "telephone_number": "772-971-6096",
            "fax_number": "949-561-4251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 37th Pl",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329606562",
            "country_code": "US",
            "telephone_number": "772-569-9788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "124131",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "241768",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "124131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.