Olga M Vysata, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25NA02876500 Issued in NJ

Practice address

146 Forest Ave
West Caldwell, NJ 07006-7970

Phone

(310) 498-0584

NPI assigned

Jan 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1326318700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 FOREST AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067970",
            "telephone_number": "310-498-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 FOREST AVE",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070067970",
            "telephone_number": "310-498-0584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Cedar Grove",
            "state": "NJ",
            "postal_code": "070091428",
            "country_code": "US",
            "telephone_number": "858-353-7422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VYSATA",
        "first_name": "OLGA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25NA02876500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in West Caldwell, NJ
• Providers in West Caldwell, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.