Individual provider Active NPI

Susan A Oliveira, RD

  • Registered Dietitian
  • Wareham, MA
National Provider Identifier
1477819845
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
3300 Issued in MA
Practice address
100 Rosebrook Way 3Rd Floor
Wareham, MA 02571-1007
Phone
(508) 273-4900
Fax
(508) 273-4901
NPI assigned
Apr 10, 2012
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 3300 MA Primary

Addresses

Primary practice location

100 Rosebrook Way 3Rd Floor
Wareham, MA 02571-1007

Mailing address

200 Mill Road Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address soliveira17185@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000916 MA Practitioner - Registered Dietitian Or Nutrition Professional 6305092180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

100 Rosebrook Way
Wareham, MA 02571-1138
Phone (508) 273-4900

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3300MAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jun 1, 2012 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jun 1, 2012 Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

100 Rosebrook Way
Fl 3
Wareham, MA 02571
Phone (508) 273-4900

Interoperability endpoints

  • Direct secure messaging: soliveira17185@direct.southcoast.org

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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1477819845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL ROAD SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROSEBROOK WAY 3RD FLOOR",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711007",
            "telephone_number": "508-273-4900",
            "fax_number": "508-273-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVEIRA",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "3300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "soliveira17185@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "100 Rosebrook Way 3rd Floor",
            "city": "Wareham",
            "state": "MA",
            "country_code": "US",
            "postal_code": "025711007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.