Individual provider Active NPI

Adam R Olsen, PA-C

  • Medical Physician Assistant
  • Trumbull, CT
National Provider Identifier
1467442533
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001463 Issued in CT
Practice address
112 Quarry Rd
Suite 400
Trumbull, CT 06611-4816
Phone
(203) 333-8800
Fax
(203) 333-6054
NPI assigned
Oct 28, 2005
Last updated
Jan 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001463 CT Primary

Addresses

Primary practice location

112 Quarry Rd
Suite 400
Trumbull, CT 06611-4816

Mailing address

112 Quarry Rd
Suite 400
Trumbull, CT 06611-4816
Phone (203) 333-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040810000773 CT Practitioner - Physician Assistant 9032181086 Reassigns benefits to 1 organization
I20251103002045 NY Practitioner - Physician Assistant 9032181086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
86.54
Promoting interoperability
99.98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001463CTMDChiropractor
009050NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. CurrentSince Jun 1, 2014 Accepting new patients
Northeast Medical Group Inc CurrentSince Jun 1, 2014 Accepting new patients
East Post Road Medical Services PC CurrentSince Sep 16, 2025 Accepting new patients

Locations

2800 Main St
Bridgeport, CT 06606
Phone (203) 386-0366

2979 Main St
Bridgeport, CT 06606
Phone (203) 333-8800

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

112 Quarry Rd
Ste 150
Trumbull, CT 06611
Phone (203) 385-1166

112 Quarry Rd
Ste 400
Trumbull, CT 06611
Phone (203) 333-8800

888 White Plains Rd
Ste 203
Trumbull, CT 06611
Phone (203) 459-0408

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: aolsen151450@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1467442533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 QUARRY RD",
            "address_2": "SUITE 400",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114816",
            "telephone_number": "203-333-8800",
            "fax_number": "203-333-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 QUARRY RD",
            "address_2": "SUITE 400",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114816",
            "telephone_number": "203-333-8800",
            "fax_number": "203-333-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "ADAM",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "001463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, CT

Sources for this page

Verify at the official NPI Registry.