Individual provider Active NPI

Olivia Amanda Pierog, MD

  • Student in an Organized Health Care Education/Training Program
  • Tarpon Springs, FL
National Provider Identifier
1760976138
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1259 S Pinellas Ave
Tarpon Springs, FL 34689-3719
Phone
(727) 938-1908
Fax
(727) 938-8693
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME168639 FL
Family Medicine Physician 207Q00000X 4301503007 MI
Student in an Organized Health Care Education/Training Program 390200000X MD Primary

Addresses

Primary practice location

1259 S Pinellas Ave
Tarpon Springs, FL 34689-3719

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-2704

Other practice location 1

1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 502-2037

Other identifiers 1

IdentifierTypeStateIssuer
45-0817179OtherMICOMMERCIAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240826004080 DC Practitioner - Family Practice 0749686400 Reassigns benefits to 1 organization
I20241105002933 VA Practitioner - Family Practice 0749686400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jul 8, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jul 8, 2024 Accepting new patients
Inova Health Care Services CurrentSince Jul 8, 2024 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2740 Prosperity Ave
Ste 200
Fairfax, VA 22031
Phone (703) 208-2273

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8001 Forbes Pl
Ste 200
Springfield, VA 22151
Phone (703) 321-2502

Interoperability endpoints

  • Direct secure messaging: oliviapierog@ccmedc.allscriptsdirect.net

Organizations & group practices 5

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1760976138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-2704",
            "fax_number": "410-500-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 S PINELLAS AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346893719",
            "telephone_number": "727-938-1908",
            "fax_number": "727-938-8693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Orleans St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870010",
            "country_code": "US",
            "telephone_number": "410-502-2037",
            "fax_number": "410-955-0737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIEROG",
        "first_name": "OLIVIA",
        "middle_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME168639",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301503007",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "45-0817179",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

Verify at the official NPI Registry.