Individual provider Active NPI

Cameron Kaehler Olderog, MD

  • Emergency Medicine Physician
  • Fort Belvoir, VA
National Provider Identifier
1588869580
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101244546 Issued in VA
Practice address
9300 Dewitt Loop
Fort Belvoir, VA 22060
Phone
(571) 321-3224
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0101244546 VA Primary

Addresses

Primary practice location

9300 Dewitt Loop
Fort Belvoir, VA 22060

Mailing address

1606 Mason Hill Dr
Alexandria, VA 22307-1929
Phone (202) 321-8454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20120322000474 DC Practitioner - Emergency Medicine 8729248174 Reassigns benefits to 1 organization
I20161122000521 VA Practitioner - Emergency Medicine 8729248174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.67 of 100Reported as group
Quality
90.2
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101244546VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Emergency Physicians PC PastSince Apr 17, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1588869580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 MASON HILL DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071929",
            "telephone_number": "202-321-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "22060",
            "telephone_number": "571-321-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDEROG",
        "first_name": "CAMERON",
        "middle_name": "KAEHLER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101244546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Belvoir, VA

Sources for this page

Verify at the official NPI Registry.