Individual provider Active NPI

Olga Kiselova, NP

  • Family Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1619670999
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
350835 Issued in NY
Practice address
117 Marys Ave
Kingston, NY 12401-5849
Phone
(845) 383-1759
NPI assigned
Mar 24, 2023
Last updated
Sep 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 350835 NY Primary

Addresses

Primary practice location

117 Marys Ave
Kingston, NY 12401-5849

Mailing address

673 Acorn Hill Rd
Olivebridge, NY 12461-5443
Phone (347) 634-3076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231012001101 NY Practitioner - Nurse Practitioner 5496100356 Reassigns benefits to 4 organizations
I20241101001097 ME Practitioner - Nurse Practitioner 5496100356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
State University of New York Downstate Medical Center, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of Maine LLCGroup PAC ID 1759621469, 34 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

50 Union St
Ellsworth, ME 04605-1534
Phone (888) 645-8829

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Dec 29, 2025 Accepting new patients
Maine Medical Services LLC CurrentSince Dec 20, 2024 Accepting new patients
St. Peter's Hospital of the City of Albany Family CurrentSince Dec 29, 2025 Accepting new patients
St. Peter's Hospital of the City of Albany CurrentSince Dec 29, 2025 Accepting new patients
Hospital Medicine Services of Maine LLC CurrentSince Dec 20, 2024 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Nov 1, 2023 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Nov 1, 2023 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

897 W Main St
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

50 Union St
Ellsworth, ME 04605
Phone (207) 664-5304

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

200 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 861-3000

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1619670999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 ACORN HILL RD",
            "city": "OLIVEBRIDGE",
            "state": "NY",
            "postal_code": "124615443",
            "telephone_number": "347-634-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015849",
            "telephone_number": "845-383-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISELOVA",
        "first_name": "OLGA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-24",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "350835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.