Individual provider Active NPI

Olivia Monira Smith

  • Physician Assistant
  • Babylon, NY
National Provider Identifier
1679481022
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
036473 Issued in NY
Practice address
400 W Main St Ste 211
Babylon, NY 11702-3009
Phone
(631) 295-5450
NPI assigned
Aug 28, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 036473 NY Primary

Addresses

Primary practice location

400 W Main St Ste 211
Babylon, NY 11702-3009

Mailing address

400 W Main St Ste 211
Babylon, NY 11702-3009

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1679481022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST STE 211",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W MAIN ST STE 211",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117023009",
            "telephone_number": "631-295-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "OLIVIA",
        "middle_name": "MONIRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-28",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "036473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.