Individual provider Active NPI

Zaida E. Olmo-Durham, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New Brunswick, NJ
National Provider Identifier
1679664007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA04593800 Issued in NJ
Practice address
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone
(732) 845-9534
Fax
(732) 220-8595
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA04593800 NJ Primary

Addresses

Primary practice location

254 Easton Ave
New Brunswick, NJ 08901-1766

Mailing address

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8534

Other identifiers 1

IdentifierTypeStateIssuer
7363206MedicaidNJ

Other names 1

  • Zaida E. Olmo Acevedo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111108000431 NJ Practitioner - Pathology 1951574938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brunswick Diagnostics Associates LLCGroup PAC ID 9537536792, 5 clinicians

Practice addresses (Care Compare)

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600

Hospital & facility affiliations

  • Saint Peter'S University Hospital Hospital, New Brunswick, NJ, CCN 310070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA04593800NJMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Diagnostics Associates LLC Anatomic Pathology & Clinical Pathology CurrentSince Dec 6, 2023 Accepting new patients
Karel Raska Jr MD - Modern Diagnostics Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

254 Easton Ave
Ste 5120
New Brunswick, NJ 08901
Phone (732) 745-8504

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

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 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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679664007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8534",
            "fax_number": "732-220-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-845-9534",
            "fax_number": "732-220-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMO-DURHAM",
        "first_name": "ZAIDA",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA04593800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7363206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZAIDA",
            "last_name": "OLMO ACEVEDO",
            "middle_name": "E.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.