Individual provider Active NPI

Michael V Oliveri, PH.D.

  • Clinical Neuropsychologist
  • Chesterfield, MO
National Provider Identifier
1417901885
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
RO299 Issued in MO
Practice address
17998 Chesterfield Airport Rd Ste 210
Chesterfield, MO 63005-1248
Phone
(636) 536-7878
Fax
(636) 536-7871
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X R0299 MO
Clinical Neuropsychologist 103G00000X RO299 MO Primary

Addresses

Primary practice location

17998 Chesterfield Airport Rd Ste 210
Chesterfield, MO 63005-1248

Mailing address

17998 Chesterfield Airport Rd Ste 210
Chesterfield, MO 63005-1248
Phone (636) 536-7878

Other identifiers 1

IdentifierTypeStateIssuer
R96802MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080708000565 MO Practitioner - Clinical Psychologist 5092887075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Missouri, Columbia School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17998 Chesterfield Airport Rd
Suite 210
Chesterfield, MO 63005-1248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
RO299MOMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael V Oliveri Clinical Neuropsychologist CurrentSince May 1, 2014 Accepting new patients
Wright & Wright, PHD, LLC Clinical Neuropsychologist Past Accepting new patients

Locations

17998 Chesterfield Airport Rd
Ste 210
Chesterfield, MO 63005
Phone (636) 536-7878

17300 North Outer 40 Rd
Ste 203
Chesterfield, MO 63005
Phone (636) 536-7878

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1417901885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17998 CHESTERFIELD AIRPORT RD STE 210",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051248",
            "telephone_number": "636-536-7878",
            "fax_number": "636-536-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17998 CHESTERFIELD AIRPORT RD STE 210",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051248",
            "telephone_number": "636-536-7878",
            "fax_number": "636-536-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERI",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "R0299",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "RO299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R96802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.