Roy Konrad Olsen, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N005647 Issued in NY

Practice address

453 Bay Ridge Pkwy
Brooklyn, NY 11209-2701

Phone

(718) 833-0869

Fax

(718) 833-0869

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1902951916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092701",
            "telephone_number": "718-833-0869",
            "fax_number": "718-833-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092701",
            "telephone_number": "718-833-0869",
            "fax_number": "718-833-0869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "ROY",
        "middle_name": "KONRAD",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02157519",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Olowo, MD
• Risikat Olowu, NP
• Olsatx LLC
• Laura Olsen, MNT
• Myanna Teresa Olsen, MD
• Tanya Olshan, SLP
• Olshanetskiy and Goutos Medicine, PC
• Russell Olshanitsky, OTR/L
• Dmitry Olshansky, M.D.
• Dean Olsher

• Podiatrist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.