Individual provider Active NPI

Oliver Kampitan Olaivar, NP

  • Family Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1669874046
Registry record updated Dec 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001043 Issued in CA
Practice address
7471 N Fresno St
Fresno, CA 93720-2457
Phone
(559) 436-4500
NPI assigned
Sep 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2014

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 95001043 CA Primary

Addresses

Primary practice location

7471 N Fresno St
Fresno, CA 93720-2457

Mailing address

7471 N Fresno St
Fresno, CA 93720-2457
Phone (559) 436-4500

Other identifiers 2

IdentifierTypeStateIssuer
GR0043790MedicaidCA
ZZZ21572ZOtherCAGRP PTAN FOR BAZ ALLERGY, ASTHMA & SINUS CENTER

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20141229000524 CA Practitioner - Nurse Practitioner 2365765211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of Veterans Affairs of the State of CaliforniaGroup PAC ID 6507099520, 18 clinicians

Practice addresses (Care Compare)

2811 W California Ave
Fresno, CA 93706-2306
Phone (559) 493-4221

Hospital & facility affiliations

  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Veterans Affairs of the State of California CurrentSince Feb 19, 2017 Accepting new patients
Department of Veterans Affairs of the State of California CurrentSince Feb 19, 2017 Accepting new patients
Department of Veterans Affairs of the State of California Current Accepting new patients

Locations

1227 O St
Rm 402
Sacramento, CA 95814

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.

Hospital & facility affiliations 1

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": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418428800000",
    "number": "1669874046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLAIVAR",
        "first_name": "OLIVER",
        "middle_name": "KAMPITAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0043790",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP PTAN FOR BAZ ALLERGY, ASTHMA & SINUS CENTER",
            "identifier": "ZZZ21572Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.