Charles E. Oltorf, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D5139 Issued in TX

Practice address

3313 Windsor Rd
Austin, TX 78703-2263

Phone

(512) 391-9025

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1417917840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 WINDSOR RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787032263",
            "telephone_number": "512-391-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 WINDSOR RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787032263",
            "telephone_number": "512-391-9025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLTORF",
        "first_name": "CHARLES",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "D5139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "807446",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010100-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR/MEDICARE",
            "identifier": "370017485",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "1010100-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Olson, MA, LPC-SUPERVISOR
• Shelby Olson
• Sierra Olson, PA-C
• Olsv6
• Megan Olszewski, LPC
• Damilola Olukoya, FNP
• Idris Oluwanisola
• Oluwatoni Oluwatofehinti, DPT
• Jaqueline Lee Olvera, LPC-ASSOCIATE
• Marissa Nicole Olvera

• Pediatrics Physician in Austin, TX
• Providers in Austin, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.