Individual provider Active NPI

Kimberly Lynn Olrich, FNP

  • Family Nurse Practitioner
  • Camillus, NY
National Provider Identifier
1407093644
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F335684-1 Issued in NY
Practice address
5639 W Genesee St
Camillus, NY 13031-1250
Phone
(315) 468-6840
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F335684-1 NY Primary

Addresses

Primary practice location

5639 W Genesee St
Camillus, NY 13031-1250

Mailing address

2585 Naughton Rd
La Fayette, NY 13084-9765
Phone (315) 677-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130627000301 NY Practitioner - Nurse Practitioner 6305085184 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of Ny Upstate Medical University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Imaging Associates PLLCGroup PAC ID 5991775553, 16 clinicians

Practice addresses (Care Compare)

5100 W Taft Rd
Suite 2a
Liverpool, NY 13088-4841
Phone (315) 452-2555

Merit-based Incentive Payment System (MIPS)

Final score
68.93 of 100Reported as group
Quality
49.97
Improvement activities
40
Cost
88.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F335684-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Associates of Central New York, LLP CurrentSince Jan 3, 2022 Accepting new patients
St. Josephs Imaging Associates PLLC CurrentSince Apr 2, 2024 Accepting new patients
Mohawk Glen Radiology Associates of Cny PLLC Past Accepting new patients

Locations

5100 W Taft Rd
Ste 2A
Liverpool, NY 13088
Phone (315) 452-2555

5100 W Taft Rd
Ste 2C
Liverpool, NY 13088
Phone (315) 452-2666

104 Union Ave
Ste 905
Syracuse, NY 13203
Phone (315) 703-5114

750 E Adams St
Rm 241
Syracuse, NY 13210
Phone (315) 464-4636

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

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": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1407093644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 NAUGHTON RD",
            "city": "LA FAYETTE",
            "state": "NY",
            "postal_code": "130849765",
            "telephone_number": "315-677-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5639 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311250",
            "telephone_number": "315-468-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLRICH",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F335684-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camillus, NY

Sources for this page

Verify at the official NPI Registry.