Olivia O'Malley, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F383479-01 Issued in NY

Practice address

6 Glen Dr
Lake Ronkonkoma, NY 11779-1506

Phone

(631) 774-9793

NPI assigned

Jan 12, 2023

Last updated

Jan 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: oliviaomalley@nslijmedgr.allscriptsdirect.net

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1669186615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 GLEN DR",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117791506",
            "telephone_number": "631-774-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 GLEN DR",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117791506",
            "telephone_number": "631-774-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "OLIVIA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383479-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ocoppola1@northwell.edu",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Northwell Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "6 Glen Dr",
            "city": "Lake Ronkonkoma",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117791506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Noonan, DPT
• North Shore Hematology Oncology Associates PC (Ny Cancer & Blood Specialists)
• North Shore Medical Group of Mt Sinai School of Medicine (North Shore Medical Group)
• Jack Z Nussbaum, MD
• Alyssandra Michelle O'Connell, MS
• Gina M. Oliva, S.L.P.
• Kyara Liz Ortiz, MSED
• Katherine Parente
• Nicholas Martin Pascullo, LPN
• Kundan A Patel

• Pediatric Nurse Practitioner in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.