Individual provider Active NPI

Kyle James Oleary, ARNP

Nurse Practitioner
Wilton Manors, FL

National Provider Identifier

1417679762

Registry record updated Aug 5, 2026

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices3
NPI Registry JSON
Other providers in Wilton Manors, FL
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Nurse PractitionerTaxonomy code 363L00000X
License: APRN11021418 Issued in FL
Practice address: 1442 NE 26TH St
Wilton Manors, FL 33305-1322
Phone: (954) 391-7160
Fax: (954) 393-0811
NPI assigned: Sep 14, 2022
Sex: Male
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 15

Specialty (taxonomy)	Code	License	State	Primary
Primary Care Nurse Practitioner	363LP2300X	1245103349	FL
Women's Health Nurse Practitioner	363LW0102X	1245103349	FL
Occupational Health Nurse Practitioner	363LX0106X	1003647587	FL
Acute Care Nurse Practitioner	363LA2100X	1003647587	FL
Diagnostic Radiology Physician	2085R0202X	JR56579000	FL
Community Health Clinic/Center	261QC1500X	1003647587	FL
Clinical Laboratory Director (Non-physician)	247ZC0005X	10D2317428	FL
Urgent Care Clinic/Center	261QU0200X	1003647587	FL
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP	363L00000X	APRN11021418	FL	Primary
Multi-Specialty Clinic/Center	261QM1300X	1245103449	FL
Diagnostic Ultrasound Physician	2085U0001X	1417679762	FL
Clinic/Center	261Q00000X	1003647587	FL
Pediatric Nurse Practitioner	363LP0200X	1245103349	FL
School Nurse Practitioner	363LS0200X	1245103349	FL
Adult Health Nurse Practitioner	363LA2200X	1245103349	FL

Addresses

Primary practice location

1442 NE 26TH St
Wilton Manors, FL 33305-1322

Mailing address

1442 NE 26TH St
Wilton Manors, FL 33305-1322
Phone (954) 391-7160

Other identifiers 10

Identifier	Type	State	Issuer
124809600	Medicaid	FL
10D2317428	Other	FL	CLIA
1417679762	Other	FL	NPI
15988989	Other		CAHQ
1003647587	Other	FL	NPI
1245103449	Other	FL	NPI
82907	Other	FL	PHARMACY
JR5657900	Other	FL	RADIOLOGY X RAY
QHU7F	Other	FL	FLORIDA BLUE
AETNA	Other	FL	8048576

Other names 1

Kyle James Oleary Professional name

Electronic endpoints 1

Type	Endpoint	Use	Affiliation
Direct Messaging Address	kyle.oleary.1@33042.direct.athenahealth.com	Direct	Island City Urgent Care

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment

Enrolled in FL

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 ID	State	Provider type	PAC ID	Details
I20241014001068	FL	Practitioner - Nurse Practitioner	7113459330

National Provider Directory

Medicare enrollment (NPD): Enrolled
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
JR56579000	FL	MD	Diagnostic Radiology Physician
1417679762	FL	MD	Diagnostic Ultrasound Physician
10D2317428	FL	MD	Clinical Laboratory Director (Non-physician)
1003647587	FL	MD	Community Health Clinic/Center
1245103449	FL	MD	Multi-Specialty Clinic/Center
1245103349	FL	MD	School Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Island City Urgent Care PA	Multi-Specialty	CurrentSince Sep 28, 2025	Accepting new patients
Denebola TR	Multi-Specialty	PastSince Jul 28, 2024	Accepting new patients
Hector L Di Carlo MD PA	Multi-Specialty	PastSince Sep 1, 2022	Accepting new patients

Locations

1442 NE 26th St
Wilton Manors, FL 33305
Phone (954) 391-7160

Interoperability endpoints

Direct secure messaging: kyle.oleary.1@33042.direct.athenahealth.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.

Island City Urgent Care PA
- General Practice Physician
- Wilton Manors, FL
- NPI 1245103449
Multi-Specialty
NPD Authorized official
Denebola TR
- Family Nurse Practitioner
- Wilton Manors, FL
- NPI 1376371450
Multi-Specialty
NPD (past)
Hector L Di Carlo MD PA
- Adult Medicine Physician
- Fort Lauderdale, FL
- NPI 1598146474
Multi-Specialty
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1417679762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1442 NE 26TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051322",
            "telephone_number": "954-391-7160",
            "fax_number": "954-393-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1442 NE 26TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051322",
            "telephone_number": "954-391-7160",
            "fax_number": "954-393-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEARY",
        "first_name": "KYLE",
        "middle_name": "JAMES",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "1245103349",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "1245103349",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "FL",
            "license": "1003647587",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "1003647587",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "JR56579000",
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "FL",
            "license": "1003647587",
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "FL",
            "license": "10D2317428",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "1003647587",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11021418",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "1245103449",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "FL",
            "license": "1417679762",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "1003647587",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "1245103349",
            "primary": false
        },
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "FL",
            "license": "1245103349",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1245103349",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124809600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2317428",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417679762",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAHQ",
            "identifier": "15988989",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003647587",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245103449",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY",
            "identifier": "82907",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADIOLOGY X RAY",
            "identifier": "JR5657900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "QHU7F",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "8048576",
            "identifier": "AETNA",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kyle.oleary.1@33042.direct.athenahealth.com",
            "affiliation": "Y",
            "endpointDescription": "athenahealth",
            "affiliationName": "Island City Urgent Care",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1442 NE 26th St",
            "city": "Wilton Manors",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333051322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "OLEARY",
            "middle_name": "JAMES",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wilton Manors, FL

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.

Verify at the official NPI Registry.