Individual provider Active NPI

Anna Olivo, NP-C

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1326569450
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8091 Issued in CT
Practice address
366 Shrewsbury St
Worcester, MA 01604-4647
Phone
(508) 595-2700
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2281279 MA
Family Nurse Practitioner 363LF0000X 8091 CT Primary

Addresses

Primary practice location

366 Shrewsbury St
Worcester, MA 01604-4647

Mailing address

139 Clark St
Rochdale, MA 01542-1139
Phone (508) 221-7314

Other practice location 1

12 Lathrop Rd
Plainfield, CT 06374-2061
Phone (860) 457-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170911001295 MA Practitioner - Nurse Practitioner 5395018584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

366 Shrewsbury St
Worcester, MA 01604-4647
Phone (508) 595-2700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8091CTMDFamily Nurse Practitioner
RN2281279MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc CurrentSince Oct 1, 2017 Accepting new patients

Locations

460 Southbridge St
Auburn, MA 01501
Phone (508) 595-2700

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

366 Shrewsbury St
Worcester, MA 01604
Phone (508) 595-2700

Interoperability endpoints

  • Direct secure messaging: anna.olivo.npi1326569450.reliant@direct.optumcare.masshiway.net

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1326569450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CLARK ST",
            "city": "ROCHDALE",
            "state": "MA",
            "postal_code": "015421139",
            "telephone_number": "508-221-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044647",
            "telephone_number": "508-595-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Lathrop Rd",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "CT",
            "postal_code": "063742061",
            "country_code": "US",
            "telephone_number": "860-457-9191",
            "fax_number": "860-457-9192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVO",
        "first_name": "ANNA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2281279",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.