Active NPI
Robert Lee Olsen, MD
- Ophthalmology Physician
- Rochester, NY
National Provider Identifier
1508826579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 150483
- Practice address
- 2301 Lac de Ville Blvd
Rochester, NY 14618-5646 - Phone
- (585) 244-0332
- Fax
- (585) 473-8833
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 150483 | NY | Primary |
Addresses
Primary practice location
2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Mailing address
2301 Lac de Ville Blvd
Rochester, NY 14618-5646
Phone (585) 244-0332
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009003140 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150483 | NY | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rochester General Hospital | Current | Accepting new patients | |
| Rochester General Hospital | Current | Accepting new patients | |
| Rochester Eye Associates Physicians and Surgeons PC | Current | Accepting new patients | |
| Rochester General Hospital | Current | Accepting new patients |
Locations
1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122
2301 Lac de Ville Blvd
Rochester, NY 14618
Phone (585) 244-0332
Organizations & group practices 4
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.
-
- Specialist
- Rochester, NY
- NPI 1619906252
-
- Family Medicine Physician
- Rochester, NY
- NPI 1356412712
-
- Family Medicine Physician
- Rochester, NY
- NPI 1174990303
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1255360517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414454400000",
"number": "1508826579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 LAC DE VILLE BLVD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146185646",
"telephone_number": "585-244-0332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 LAC DE VILLE BLVD",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146185646",
"telephone_number": "585-244-0332",
"fax_number": "585-473-8833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "ROBERT",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-24",
"last_updated": "2014-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "150483",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009003140",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.