Individual provider Active NPI

Carly Oliveri, PA-C

  • Physician Assistant
  • Miami Beach, FL
National Provider Identifier
1730657131
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112268 Issued in FL
Practice address
542 W 41St St
Miami Beach, FL 33140-3510
Phone
(305) 397-8417
NPI assigned
Nov 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0228831 NY
Physician Assistant 363A00000X 9112268 FL Primary

Addresses

Primary practice location

542 W 41St St
Miami Beach, FL 33140-3510

Mailing address

542 W 41St St
Miami Beach, FL 33140-3510
Phone (305) 397-8417

Other practice location 1

9333 SW 152nd St
Palmetto Bay, FL 33157-1778
Phone (305) 251-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181217002716 NY Practitioner - Physician Assistant 4981949120 Reassigns benefits to 1 organization
I20200610000125 FL Practitioner - Physician Assistant 4981949120 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9112268FLMDPhysician Assistant
0228831NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Nov 19, 2018 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Mar 29, 2024 Accepting new patients
Inmotion Health, P.a. Current Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Mar 29, 2024 Accepting new patients

Locations

4825 SW 148th Ave
Davie, FL 33330
Phone (954) 526-7291

915 W 49th St
Hialeah, FL 33012
Phone (305) 200-1225

1 Gustave L Levy Pl
Fl 12
New York, NY 10029
Phone (212) 241-1518

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Interoperability endpoints

  • Direct secure messaging: carly.oliveri.1@33347.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1730657131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 W 41ST ST",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403510",
            "telephone_number": "305-397-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 W 41ST ST",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331403510",
            "telephone_number": "305-397-8417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9333 SW 152nd St",
            "address_purpose": "LOCATION",
            "city": "Palmetto Bay",
            "state": "FL",
            "postal_code": "331571778",
            "country_code": "US",
            "telephone_number": "305-251-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVERI",
        "first_name": "CARLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-05",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "0228831",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.