Individual provider Active NPI

Agata Katarzyna Olszowska, M.D.

  • Family Medicine Physician
  • Waterloo, NY
National Provider Identifier
1760406177
Registry record updated Sep 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
255097 Issued in NY
Practice address
367 E Main St Ste a
Waterloo, NY 13165-1643
Phone
(315) 787-4977
Fax
(315) 787-4973
NPI assigned
Jul 27, 2006
Last updated
Sep 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 255097 NY Primary

Addresses

Primary practice location

367 E Main St Ste a
Waterloo, NY 13165-1643

Mailing address

932 Hastings Rd
Geneva, NY 14456-9135
Phone (419) 706-1497

Other identifiers 4

IdentifierTypeStateIssuer
34170154302OtherOHBUREAU OF WORKERS COMPENS
080181051OtherRAILROAD MEDICARE
2261609MedicaidOH
000000205442OtherOHANTHEM BC/BS

Other names 1

  • Dr. Agata Katarzyna Zgleszewski Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20091123000238 NY Practitioner - Family Practice 5991702987 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical, PC CurrentSince Jun 21, 2012 Accepting new patients
FLH Medical, PC Family Medicine CurrentSince Jun 21, 2012 Accepting new patients
Geneva General Hospital, Inc. Family Medicine CurrentSince Oct 16, 2016 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Family Health Partners, Inc. Family Medicine Past Accepting new patients
Innovative Hospital Care Inc Past Accepting new patients
Fisher-Titus Medical Care LLC Family Medicine Past Accepting new patients

Locations

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

196 North St
Geneva, NY 14456
Phone (315) 787-4156

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

367 E Main St
Ste A
Waterloo, NY 13165
Phone (315) 787-4977

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315353600000",
    "number": "1760406177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 HASTINGS RD",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144569135",
            "telephone_number": "419-706-1497",
            "fax_number": "315-787-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 E MAIN ST STE A",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651643",
            "telephone_number": "315-787-4977",
            "fax_number": "315-787-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSZOWSKA",
        "first_name": "AGATA",
        "middle_name": "KATARZYNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2011-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "255097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF WORKERS COMPENS",
            "identifier": "34170154302",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080181051",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2261609",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000205442",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGATA",
            "last_name": "ZGLESZEWSKI",
            "middle_name": "KATARZYNA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waterloo, NY

Sources for this page

Verify at the official NPI Registry.