Olga E Reavill, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MA10701700 Issued in NJ

Practice address

731 Hwy 35 Unit G
Ocean, NJ 07712-4765

Phone

(732) 455-8444

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Altus Exceptional Physician Group PLLC

  • Emergency Medicine Physician
  • Orange, TX
  • NPI 1730869207
  Medicare reassignment NPD
• Austin ER Associates PLLC

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1376114587
  Medicare reassignment NPD
• Concord Medical Group of Texas PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1750790762
  Medicare reassignment NPD
• Texas ER Group PLLC

  • Emergency Medicine Physician
  • Lumberton, TX
  • NPI 1235829359
  Medicare reassignment NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1740240647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 PACIFIC ST",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077407274",
            "telephone_number": "337-255-4081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 HWY 35 UNIT G",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077124765",
            "telephone_number": "732-455-8444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16902 Harkey Road, Cr 103",
            "address_purpose": "LOCATION",
            "city": "Pearland",
            "state": "TX",
            "postal_code": "77584",
            "country_code": "UM",
            "telephone_number": "337-255-4081",
            "country_name": "United States Minor Outlying Islands",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "REAVILL",
        "first_name": "OLGA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "MD.L07184R",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "H6764",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "MD.L07184R",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10701700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DISPENSING REGISTRATION",
            "identifier": "DISP.200276",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1388441",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda A Pullano, PT
• Vicki E Raab, M.D.
• Robert William Rachlin, DMD
• Brian R Rath, PA
• Rebecca Genevieve Rean, LPC
• Matthew Reda, PA
• Resolutions Counseling and Mediation, LLC
• Liza Anne Restifo, LCSW, LCADC
• Joshua D. Reyes, OTD, OTR
• Lacey Richard, FNP

• Anesthesiology Physician in Ocean, NJ
• Providers in Ocean, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.