Individual provider Active NPI

Jessica Olson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Chelmsford, MA
National Provider Identifier
1659799971
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2459 Issued in MA
Practice address
4 Courthouse LN
Chelmsford, MA 01824-1728
Phone
(978) 441-9241
Fax
(978) 970-0248
NPI assigned
Apr 3, 2014
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2459 MA Primary

Addresses

Primary practice location

4 Courthouse LN
Chelmsford, MA 01824-1728

Mailing address

4 Courthouse LN
Chelmsford, MA 01824-1728
Phone (480) 235-0811

Other identifiers 2

IdentifierTypeStateIssuer
1659799971OtherNPI
2459OtherMAMASSACHUSETTS PODIATRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2459MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael D. Kotzen, Inc. Single Specialty CurrentSince Feb 1, 2023 Accepting new patients
Summit Place LLC Single Specialty CurrentSince Mar 16, 2021 Accepting new patients

Locations

12520 Magnolia Blvd
Ste 304
Valley Vlg, CA 91607
Phone (818) 452-9902

4 Courthouse Ln
Ste 11
Chelmsford, MA 01824
Phone (978) 441-9241

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659799971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COURTHOUSE LN",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018241728",
            "telephone_number": "480-235-0811",
            "fax_number": "978-970-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COURTHOUSE LN",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018241728",
            "telephone_number": "978-441-9241",
            "fax_number": "978-970-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "JESSICA",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "2459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659799971",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS PODIATRY LICENSE",
            "identifier": "2459",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

Verify at the official NPI Registry.