Individual provider Active NPI

Joe A Olivi, MD

  • Surgery Physician
  • Orlando, FL
National Provider Identifier
1578663191
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME152122 Issued in FL
Practice address
9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015
Phone
(407) 354-1202
Fax
(407) 351-8801
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E11250 AR
Surgery Physician 208600000X 2008035007 MO
Surgery Physician 208600000X ME152122 FL Primary

Addresses

Primary practice location

9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015

Mailing address

9430 Turkey Lake Rd Ste 114
Orlando, FL 32819-8015
Phone (407) 354-1202

Other practice location 1

1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 884-1615

Other practice location 2

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 3

100 Mercy Way Ste 440
Joplin, MO 64804-4524
Phone (417) 781-4404

Other identifiers 2

IdentifierTypeStateIssuer
111433200MedicaidFL
200057404MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090413000115 MO Practitioner - General Surgery 7214084136 Reassigns benefits to 1 organization
I20180420000773 AR Practitioner - General Surgery 7214084136 Reassigns benefits to 6 organizations
I20210827002164 FL Practitioner - General Surgery 7214084136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Joplin LLCGroup PAC ID 0547300196, 288 clinicians

Practice addresses (Care Compare)

100 Mercy Way
440 General and Specialty Surgery
Joplin, MO 64804-4524
Phone (417) 781-4404

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E11250ARMDSurgery Physician
2008035007MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Childrens Hospital CurrentSince Jul 1, 2020 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2018 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 14, 2021 Accepting new patients
Mercy Health Northwest Arkansas Communities Surgery CurrentSince Jan 14, 2021 Accepting new patients
Florida Clinical Practice Association Inc Surgery CurrentSince Sep 1, 2021 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2020 Accepting new patients
Arkansas Children'S Hospital CurrentSince Jul 1, 2020 Accepting new patients
Mercy Clinic Joplin LLC Surgery CurrentSince Mar 1, 2023 Accepting new patients
Northwest Physicians LLC CurrentSince May 1, 2018 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jul 1, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jan 14, 2021 Accepting new patients
St Mary'S Physician Services LLC CurrentSince Sep 13, 2024 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 1, 2024 Accepting new patients
St Marys Physician Services, LLC CurrentSince Sep 13, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 1, 2021 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

4301 W Markham St
Ste 528
Little Rock, AR 72205

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

4301 W Markham St
#528
Little Rock, AR 72205
Phone (501) 614-2006

1001 S Horsebarn Rd
Rogers, AR 72758
Phone (479) 273-7700

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

601 W Maple Ave
Ste 403
Springdale, AR 72764
Phone (479) 750-2742

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
#100109
Gainesville, FL 32610

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9430 Turkey Lake Rd
Ste 114
Orlando, FL 32819
Phone (407) 354-1202

1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568

100 Mercy Way
#440
Joplin, MO 64804
Phone (417) 781-4404

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

100 Mercy Way
Ste 440
Joplin, MO 64804
Phone (417) 781-4404

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

Organizations & group practices 20

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 20

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1578663191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 114",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "407-354-1202",
            "fax_number": "407-351-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 114",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "407-354-1202",
            "fax_number": "407-351-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652120001",
            "country_code": "US",
            "telephone_number": "573-884-1615",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Way # 653",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Mercy Way Ste 440",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648044524",
            "country_code": "US",
            "telephone_number": "417-781-4404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVI",
        "first_name": "JOE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "E11250",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2008035007",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME152122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111433200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200057404",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.