Active NPI
Maria A. Olivo, O.D.
- Optometrist
- Lumberton, NJ
National Provider Identifier
1356470892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OA05517
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3046351 | Other | NJ | AETNA |
| 115660 | Other | NJ | EYEMED |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OA05517 | NJ | MD | Optometrist |
| 2116 | SC | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aeg South Carolina Professional PC | Optometrist | Current | 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.
-
- Optometrist
- Columbia, SC
- NPI 1720768427
-
- Optometrist
- Lumberton, NJ
- NPI 1720228729
-
- Optometrist
- Myrtle Beach, SC
- NPI 1972621423
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.