Individual provider Active NPI

Olivia Julia Karczewski, PA-C

  • Medical Physician Assistant
  • Hoboken, NJ
National Provider Identifier
1487269015
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00851000 Issued in NJ
Practice address
1425 Bloomfield St
Hoboken, NJ 07030-5505
Phone
(201) 706-8490
Fax
(201) 285-6514
NPI assigned
Sep 10, 2020
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025588 NY
Medical Physician Assistant 363AM0700X 25MP00851000 NJ Primary

Addresses

Primary practice location

1425 Bloomfield St
Hoboken, NJ 07030-5505

Mailing address

7764 76TH St
Glendale, NY 11385-8239
Phone (347) 907-2430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 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
I20220817001651 NY Practitioner - Physician Assistant 1153704507 Reassigns benefits to 1 organization
I20240918004862 NJ Practitioner - Physician Assistant 1153704507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

506 Broadway
Bayonne, NJ 07002-3712
Phone (201) 471-7012

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
99.47
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025588NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Sep 1, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Sep 1, 2024 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Advanced Diagnostic Imaging PLLC Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

Networks

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

Interoperability endpoints

  • Direct secure messaging: okarczewski128829@direct.optum.com

Organizations & group practices 5

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1487269015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7764 76TH ST",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113858239",
            "telephone_number": "347-907-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 BLOOMFIELD ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305505",
            "telephone_number": "201-706-8490",
            "fax_number": "201-285-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARCZEWSKI",
        "first_name": "OLIVIA",
        "middle_name": "JULIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025588",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00851000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.