Individual provider Active NPI

Maria A. Olivo, O.D.

  • Optometrist
  • Lumberton, NJ
National Provider Identifier
1356470892
Registry record updated Oct 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA05517 Issued in NJ
Practice address
1636 Route 38 Ste 48
Lumberton, NJ 08048-2988
Phone
(609) 702-7300
Fax
(609) 702-7385
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OA05517 NJ Primary

Addresses

Primary practice location

1636 Route 38 Ste 48
Lumberton, NJ 08048-2988

Mailing address

1636 Route 38 Ste 48
Lumberton, NJ 08048-2988
Phone (609) 702-7300

Other identifiers 2

IdentifierTypeStateIssuer
3046351OtherNJAETNA
115660OtherNJEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240819003467 SC Practitioner - Optometry 9133158033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OA05517NJMDOptometrist
2116SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg South Carolina Professional PC Optometrist CurrentSince May 29, 2024 Accepting new patients
Carolina Forest Family Eyecare, P.a. Optometrist Past Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

644 N Main St
Ste 109
Greenville, SC 29601
Phone (864) 900-0671

4225 Carolina Exchange Dr
#A
Myrtle Beach, SC 29579
Phone (843) 903-6262

Organizations & group practices 3

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1356470892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 ROUTE 38 STE 48",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482988",
            "telephone_number": "609-702-7300",
            "fax_number": "609-702-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 ROUTE 38 STE 48",
            "city": "LUMBERTON",
            "state": "NJ",
            "postal_code": "080482988",
            "telephone_number": "609-702-7300",
            "fax_number": "609-702-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVO",
        "first_name": "MARIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA05517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3046351",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "115660",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lumberton, NJ

Sources for this page

Verify at the official NPI Registry.