Individual provider Active NPI

Cedric Keir Olivera, MD, MS

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • New York, NY
National Provider Identifier
1568638997
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
236536 Issued in NY
Practice address
90 Maiden LN
FL 3
New York, NY 10038-4831
Phone
(646) 290-9560
Fax
(212) 532-4362
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 236536-1 NY
Gynecology Physician 207VG0400X MA66558 NJ
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X 236536 NY Primary

Addresses

Primary practice location

90 Maiden LN
FL 3
New York, NY 10038-4831

Mailing address

PO Box 26481
Brooklyn, NY 11202-6481
Phone (732) 740-4495

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090105000198 NY Practitioner - Obstetrics/GynecologyPractitioner - Urology 6406742295 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians
Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians
Physician Affiliate Group of New York PCGroup PAC ID 4688098833, 1,222 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8425

1605 Voorhies Ave
Suite 1
Brooklyn, NY 11235-3982
Phone (347) 492-6722

200 Livingston St
Brooklyn, NY 11201-5811
Phone (718) 522-3399

2601 Ocean Pkwy
Brooklyn, NY 11235-7745
Phone (718) 616-5356

Hospital & facility affiliations

  • South Brooklyn Health Hospital, Brooklyn, NY, CCN 330196
  • Brooklyn Hospital Center - Downtown Campus Hospital, Brooklyn, NY, CCN 330056

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

State licenses

LicenseStateTypeSpecialty
236536-1NYMDRegistered Nurse
236536NYMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NYU Langone Hospitals Current Accepting new patients
NYU Langone Hospitals CurrentSince Jan 1, 2016 Accepting new patients
New York University CurrentSince Sep 1, 2015 Accepting new patients
NYU Langone Hospitals CurrentSince Jan 1, 2016 Accepting new patients
Coney Island Medical Practice Plan, P.C. CurrentSince Dec 4, 2018 Accepting new patients
Amboy Medical Practice PC CurrentSince Jul 25, 2018 Accepting new patients
TBHC Physician Services PC CurrentSince Aug 1, 2018 Accepting new patients
Amboy Medical Practice PC CurrentSince Jul 25, 2018 Accepting new patients
Century Medical & Dental Center Inc CurrentSince Aug 11, 2018 Accepting new patients
New York University CurrentSince Sep 1, 2015 Accepting new patients
Suny Health Science Center at Brooklyn Gynecology Past Accepting new patients
Neighborhood Health Services Corporation Past Accepting new patients
Ny Pelvic Pain and Minimally Invasive Gynecologic Surgery PC Gynecology PastSince Nov 15, 2017 Accepting new patients
TBHC Medical Services PC Past Accepting new patients
Suny Downstate Medical Center Past Accepting new patients

Locations

260 Avenue X
Brooklyn, NY 11223
Phone (718) 336-8855

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

150 55th St
Rm 3618
Brooklyn, NY 11220
Phone (718) 630-7477

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

200 Livingston St
Brooklyn, NY 11201
Phone (718) 522-3399

523 Fulton St
Ste 2
Brooklyn, NY 11201
Phone (718) 250-8425

3007 Farragut Rd
Brooklyn, NY 11210
Phone (347) 915-1177

8714 5th Ave
Brooklyn, NY 11209
Phone (718) 630-8600

97 Amity St
Brooklyn, NY 11201
Phone (718) 780-1025

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

111 Broadway
Fl 2
Trinity, NY 10006
Phone (212) 263-9700

Networks

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

Interoperability endpoints

  • Direct secure messaging: colivera574188@nychhc.direct-ci.com

Organizations & group practices 17

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.

View all 17

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1568638997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26481",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112026481",
            "telephone_number": "732-740-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAIDEN LN",
            "address_2": "FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384831",
            "telephone_number": "646-290-9560",
            "fax_number": "212-532-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERA",
        "first_name": "CEDRIC",
        "middle_name": "KEIR",
        "name_prefix": "Dr.",
        "credential": "MD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "236536-1",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "MA66558",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "NY",
            "license": "236536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.