Individual provider Active NPI

Olga Vishneva, D.O.

  • Anesthesiology Physician
  • Neptune City, NJ
National Provider Identifier
1619409950
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MB11269100 Issued in NJ
Practice address
1945 Route 33
Neptune City, NJ 07753
Phone
(732) 775-5500
NPI assigned
Mar 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MB11269100 NJ Primary

Addresses

Primary practice location

1945 Route 33
Neptune City, NJ 07753

Mailing address

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1926

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2012
Phone (718) 270-1926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20211026001329 NJ Practitioner - Anesthesiology 1658769526 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11269100NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olena Medical New Jersey LLC Anesthesiology CurrentSince Jun 6, 2025 Accepting new patients
Omnj Division Two LLC Anesthesiology CurrentSince Sep 11, 2025 Accepting new patients

Locations

1255 Broad St
Ste 200
Bloomfield, NJ 07003
Phone (646) 740-8302

146 N State Rt 17
Ste A1
Hackensack, NJ 07601
Phone (551) 999-9064

360 Route 70
Lakewood, NJ 08701
Phone (732) 367-3050

Organizations & group practices 3

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1619409950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032012",
            "telephone_number": "718-270-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 33",
            "city": "NEPTUNE CITY",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-775-5500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032012",
            "country_code": "US",
            "telephone_number": "718-270-1926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VISHNEVA",
        "first_name": "OLGA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MB11269100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune City, NJ

Sources for this page

Verify at the official NPI Registry.