Individual provider Active NPI

Olga Maria Vizcaino, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Des Moines, WA
National Provider Identifier
1326728809
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023018462 Issued in FL
Practice address
22207 7TH Ave S
Des Moines, WA 98198-6221
Phone
(206) 588-5251
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023018462 FL Primary

Addresses

Primary practice location

22207 7TH Ave S
Des Moines, WA 98198-6221

Mailing address

11016 W 33Rd Way
Hialeah, FL 33018-2196
Phone (786) 459-2466

Other practice location 1

11016 W 33rd Way
Hialeah, FL 33018-2196
Phone (786) 459-2466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, WA, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231221002821 FL Practitioner - Nurse Practitioner 1951751510 Reassigns benefits to 2 organizations
I20240315003115 WA Practitioner - Nurse Practitioner 1951751510 Reassigns benefits to 1 organization
I20240507000531 NY Practitioner - Nurse Practitioner 1951751510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Health Psychiatric Services PCGroup PAC ID 2365789674, 26 clinicians

Practice addresses (Care Compare)

6219 5TH Ave
Brooklyn, NY 11220-4611
Phone (718) 522-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023018462FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles (10 of 14)

OrganizationSpecialtyStatusNew patients
Health First Nursing Services Inc CurrentSince Jul 1, 2023 Accepting new patients
Santa Ana Medical Care Center Inc CurrentSince Feb 1, 2026 Accepting new patients
South Florida Psychiatry Group, PA Psychiatric/Mental Health CurrentSince Nov 18, 2023 Accepting new patients
Good Health Psychiatric Services PC CurrentSince Apr 1, 2024 Accepting new patients
Pursuit Mental Health and Recovery Psychiatric/Mental Health CurrentSince Feb 1, 2024 Accepting new patients
South Florida Psychiatry Psychiatric/Mental Health PastSince Feb 1, 2022 Accepting new patients
Mental Health 1St PLLC Psychiatric/Mental Health Past Accepting new patients
East Point Medical PC Psychiatric/Mental Health Past Accepting new patients
Golden Phoenix Mental Health LLC Past Accepting new patients
Rudoy Medical PC Past Accepting new patients

Locations

3750 W 16th Ave
Ste 104
Hialeah, FL 33012
Phone (305) 200-5648

3750 W 16th Ave
Ste 104114
Hialeah, FL 33012
Phone (305) 200-5648

8950 SW 74th Ct
Ste 2201
Miami, FL 33156
Phone (305) 238-9855

8950 SW 74th Ct
Ste 1911
Miami, FL 33156
Phone (305) 670-0641

26 Court St
Ste 808
Brooklyn, NY 11242
Phone (718) 307-1577

6219 5th Ave
Brooklyn, NY 11220
Phone (718) 307-1577

26 Court St
Ste 1510
Brooklyn, NY 11242
Phone (718) 522-3600

22207 7th Ave S
Des Moines, WA 98198
Phone (206) 588-5251

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 10

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": "1689811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1326728809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11016 W 33RD WAY",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330182196",
            "telephone_number": "786-459-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22207 7TH AVE S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986221",
            "telephone_number": "206-588-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11016 W 33rd Way",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330182196",
            "country_code": "US",
            "telephone_number": "786-459-2466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIZCAINO",
        "first_name": "OLGA",
        "middle_name": "MARIA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-20",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2023018462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

Verify at the official NPI Registry.