Edith Jenissa Oliveras, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

L4596 Issued in TX

Practice address

2410 E Riverside Dr Ste G3
Austin, TX 78741-3053

Phone

(512) 448-3778

Fax

(512) 448-3776

NPI assigned

Dec 18, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Pediatric Medicine

Education

Ponce School of Medicine, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Central Texas Community Health Centers

  dba CommUnityCare

  • Family Medicine Physician
  • Austin, TX
  • NPI 1427882091
  Medicare reassignment NPD
• Central Texas Community Health Centers

  dba CommUnityCare

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1861555195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 E RIVERSIDE DR STE G3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413053",
            "telephone_number": "512-448-3778",
            "fax_number": "512-448-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 E RIVERSIDE DR STE G3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787413053",
            "telephone_number": "512-448-3778",
            "fax_number": "512-448-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVERAS",
        "first_name": "EDITH",
        "middle_name": "JENISSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L4596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155187102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715105",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153715107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martha Suzanne Oliver, LCSW, CSW-G
• Michael Brian Oliver, MD
• Natalee Oliver
• Paula S. Oliver, M.D.
• Juan Olivera, MA, LPC, LCDC
• Ana Oliveros Parra
• Monica Oliveto, M.D.
• Olivia Calder, MSN, Aprn, Pmhnp-BC, PLLC (Calder Psychotherapy & Psychiatry)
• Olivia Yun MD Family Medicine PLLC
• Kimberly Olivier, RN

• Pediatrics Physician in Austin, TX
• Providers in Austin, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.