Individual provider Active NPI

Olivia Mannix, PA

  • Medical Physician Assistant
  • New York, NY
National Provider Identifier
1861388951
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
034116 Issued in NY
Practice address
535 W 110TH St Apt 1E
New York, NY 10025-2021
Phone
(212) 280-4740
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 034116 NY
Medical Physician Assistant 363AM0700X 034116 NY Primary

Addresses

Primary practice location

535 W 110TH St Apt 1E
New York, NY 10025-2021

Mailing address

535 W 110TH St Apt 1E
New York, NY 10025-2021
Phone (212) 280-4740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250923003831 NY Practitioner - Physician Assistant 3375048168 Reassigns benefits to 1 organization
I20251021003840 NJ Practitioner - Physician Assistant 3375048168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

535 W 110TH St
Apt 1E
New York, NY 10025-2021

535 W 110TH St Apt
1E
New York, NY 10025-2021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
034116NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Chiropractic Enterprise PLLC Past Accepting new patients
Practice Associates Medical Group PastSince Oct 5, 2025 Accepting new patients

Organizations & group practices 3

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1861388951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252021",
            "telephone_number": "212-280-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252021",
            "telephone_number": "212-280-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNIX",
        "first_name": "OLIVIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "034116",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "034116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.