Organization Active NPI

Olga Freeman MD PA

  • Primary Care Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1669502704
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME68876 Issued in FL
Legal business name
OLGA FREEMAN MD PA
Doing business as
Olga Freeman, M.D.,P.a.
Practice address
13641 Metropolis Ave
Suite 101
Fort Myers, FL 33912
Phone
(239) 225-7261
Fax
(239) 225-7945
NPI assigned
Mar 7, 2007
Last updated
Nov 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Authorized official

Name
Nancy E Williams
Title
Medical Billing/Coding Clerk
Phone
(239) 225-7261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME68876 FL Primary

Addresses

Primary practice location

13641 Metropolis Ave
Suite 101
Fort Myers, FL 33912

Mailing address

13641 Metropolis Ave
Suite 101
Fort Myers, FL 33912
Phone (239) 225-7261

Other identifiers 1

IdentifierTypeStateIssuer
AC380OtherFLMEDICARE

Other names 1

  • OLGA FREEMAN, M.D.,P.A. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000469 FL Part B Supplier - Clinic/Group Practice 3274630959 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0914500Olga Freeman MD PA13641 Metropolis Ave Suite 101, Fort Myers, FL 33912Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory

Locations

13641 Metropolis Ave
Ste 101
Fort Myers, FL 33912
Phone (239) 225-7261

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIHIAA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1669502704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13641 METROPOLIS AVE",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-225-7261",
            "fax_number": "239-225-7945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13641 METROPOLIS AVE",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-225-7261",
            "fax_number": "239-225-7945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLGA FREEMAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL BILLING/CODING CLERK",
        "authorized_official_telephone_number": "239-225-7261"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME68876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "AC380",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLGA FREEMAN, M.D.,P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.