Jose A. Olivencia, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

19393 Issued in IA

Practice address

2425 Westown Pkwy
West Des Moines, IA 50266-1425

Phone

(515) 222-8346

Fax

(515) 222-0472

NPI assigned

Aug 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Iowa Vein Center, Inc.

  • Surgery Physician
  • West Des Moines, IA
  • NPI 1649394842
  Authorized official Same address or phone

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821101478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661425",
            "telephone_number": "515-222-8346",
            "fax_number": "515-222-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661425",
            "telephone_number": "515-222-8346",
            "fax_number": "515-222-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVENCIA",
        "first_name": "JOSE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "19393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "20015691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "6702",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "02396",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025355600",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1151837",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1700237",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "663357",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Ae Ohnesorge, PHARMD
• Erica Holst Olberding, DDS
• Peter Vincent Olberding, DDS
• Dominique Oldham, OTA
• Olive Branch Health Care Services PLLC
• Breeley Rian Oliver
• Lindsey Olsen
• Evan Olson
• James Olson, RPH
• Kyle R Olson, D.D.S.

• Surgery Physician in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Surgery Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.