Individual provider Active NPI

Angie Oliveros

  • Nurse Massage Therapist (NMT)
  • Island Park, NY
National Provider Identifier
1417890997
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X
License
N00757 Issued in NY
Practice address
94 California PL S
Island Park, NY 11558-2201
Phone
(934) 212-9849
NPI assigned
Apr 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Massage Therapist (NMT) 163WM1400X N00757 NY Primary

Addresses

Primary practice location

94 California PL S
Island Park, NY 11558-2201

Mailing address

94 California PL S
Island Park, NY 11558-2201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
N00757NYMDNurse Massage Therapist (NMT)

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1417890997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CALIFORNIA PL S",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115582201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 CALIFORNIA PL S",
            "city": "ISLAND PARK",
            "state": "NY",
            "postal_code": "115582201",
            "telephone_number": "934-212-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEROS",
        "first_name": "ANGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "NY",
            "license": "N00757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.