Individual provider Active NPI

Olivia A Casimir, PA-C

  • Physician Assistant
  • Bristol, CT
National Provider Identifier
1447001060
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6773 Issued in CT
Practice address
25 Newell Rd Ste E36
Bristol, CT 06010-5132
Phone
(860) 583-9252
Fax
(860) 585-9848
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6773 CT Primary

Addresses

Primary practice location

25 Newell Rd Ste E36
Bristol, CT 06010-5132

Mailing address

78 Roberta Dr
Middletown, CT 06457-5510
Phone (404) 718-9514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241004000949 CT Practitioner - Physician Assistant 3072044718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Connecticut Gi PLLCGroup PAC ID 9830110758, 243 clinicians

Practice addresses (Care Compare)

85 Seymour St
Suite 1000
Hartford, CT 06106-5529
Phone (860) 246-2571

Hospital & facility affiliations

  • Bristol Hospital Hospital, Bristol, CT, CCN 070029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Litchfield County Gastroenterology Associates, LLC Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1447001060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ROBERTA DR",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575510",
            "telephone_number": "404-718-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 NEWELL RD STE E36",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105132",
            "telephone_number": "860-583-9252",
            "fax_number": "860-585-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASIMIR",
        "first_name": "OLIVIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.