Individual provider Active NPI

P Michael Olmstead, MD

  • Anatomic Pathology Physician
  • Harrisburg, PA
National Provider Identifier
1356334874
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
MD028503E Issued in PA
Practice address
111 South Front Street
Harrisburg, PA 17111-8700
Phone
(717) 782-5640
Fax
(717) 782-5352
NPI assigned
Aug 30, 2005
Last updated
Jan 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X MD028503E PA
Anatomic Pathology Physician 207ZP0101X MD028503E PA Primary

Addresses

Primary practice location

111 South Front Street
Harrisburg, PA 17111-8700

Mailing address

4520 Union Deposit Rd
Harrisburg, PA 17111-2910
Phone (717) 652-6105

Other identifiers 2

IdentifierTypeStateIssuer
0009113170005MedicaidPA
0009118170001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD028503EPAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates of Central Pennsylvania PC Dermatopathology PastSince Jul 27, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1356334874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 UNION DEPOSIT RD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171112910",
            "telephone_number": "717-652-6105",
            "fax_number": "717-652-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SOUTH FRONT STREET",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171118700",
            "telephone_number": "717-782-5640",
            "fax_number": "717-782-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMSTEAD",
        "first_name": "P",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "PA",
            "license": "MD028503E",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "PA",
            "license": "MD028503E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009113170005",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009118170001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.