Individual provider Active NPI

Olivia Kraemer, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Moorestown, NJ
National Provider Identifier
1366069197
Registry record updated Jun 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
73 Brooks Rd
Moorestown, NJ 08057-3855
Phone
(856) 630-4765
NPI assigned
Jun 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

73 Brooks Rd
Moorestown, NJ 08057-3855

Mailing address

73 Brooks Rd
Moorestown, NJ 08057-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20201210000261 NJ Practitioner - Physician Assistant 5799197075 Reassigns benefits to 1 organization
I20240930004019 CA Practitioner - Physician Assistant 5799197075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

Practice addresses (Care Compare)

3737 Moraga Ave
Suite B103
San Diego, CA 92117-5352
Phone (858) 799-0855

4275 Mission Bay Dr
San Diego, CA 92109-5775

6551 Mission Gorge Rd
San Diego, CA 92120-2306
Phone (858) 554-1212

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
73.9

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
UC San Diego Health - Rancho Family Medical Group Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: okraemer330531@ahs.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593216000000",
    "number": "1366069197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 BROOKS RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 BROOKS RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573855",
            "telephone_number": "856-630-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAEMER",
        "first_name": "OLIVIA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-27",
        "last_updated": "2020-06-27",
        "certification_date": "2020-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.