Individual provider Active NPI

Oliver Theodore Ines Tolentino, MSN, NP, AGNP-C

  • Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1831926609
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15150300 Issued in NJ
Practice address
33 Overlook Rd. Mac 1
Suite 301
Summit, NJ 07901
Phone
(908) 522-5045
Fax
(908) 522-5353
NPI assigned
Sep 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15150300 NJ Primary

Addresses

Primary practice location

33 Overlook Rd. Mac 1
Suite 301
Summit, NJ 07901

Mailing address

19 William St
Summit, NJ 07901-3447
Phone (718) 304-6306

Other practice location 1

1125 Rt 22 West
Suite 265
Bridgewater, NJ 08807
Phone (908) 947-7015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250507001763 NJ Practitioner - Nurse Practitioner 3577080175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15150300NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Feb 24, 2025 Accepting new patients

Locations

1125 US Highway 22
Ste 265
Bridgewater, NJ 08807
Phone (908) 522-5045

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

33 Overlook Rd
Ste 301
Summit, NJ 07901
Phone (908) 522-5045

33 Overlook Rd
Ste 301
Summit, NJ 07901
Phone (908) 277-1122

Interoperability endpoints

  • Direct secure messaging: otolentino90654@direct.ahsys.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1831926609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WILLIAM ST",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013447",
            "telephone_number": "718-304-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD. MAC 1",
            "address_2": "SUITE 301",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-522-5045",
            "fax_number": "908-522-5353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 Rt 22 West",
            "address_2": "Suite 265",
            "address_purpose": "LOCATION",
            "city": "Bridgewater",
            "state": "NJ",
            "postal_code": "08807",
            "country_code": "US",
            "telephone_number": "908-947-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "OLIVER THEODORE",
        "middle_name": "INES",
        "credential": "MSN, NP, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15150300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.