NPIMap

Individual provider Active NPI

Gregory Olsen

  • Anatomic Pathology & Clinical Pathology Physician
  • New Haven, CT
National Provider Identifier
1922460955
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME151102 Issued in FL
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME151102 FL Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

PO Box 100275
Gainesville, FL 32610-0275
Phone (352) 273-7839

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3220
Phone (352) 273-7839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210726000812 FL Practitioner - Pathology 0840587580 Reassigns benefits to 1 organization
I20240220002968 SC Practitioner - Pathology 0840587580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Georgia School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates of GreenvilleGroup PAC ID 9537072897, 33 clinicians

Practice addresses (Care Compare)

701 Grove Rd
Greenville, SC 29605-4210
Phone (864) 295-3492

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME151102FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 1, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 1, 2021 Accepting new patients
Pathology Associates of Greenville PA Anatomic Pathology & Clinical Pathology CurrentSince Feb 6, 2024 Accepting new patients
Pathology Consultants, Inc Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100275
Gainesville, FL 32610
Phone (352) 273-7839

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

8 Memorial Medical Ct
Ste 1
Greenville, SC 29605
Phone (864) 295-3492

8 Memorial Medical Ct
Greenville, SC 29605
Phone (864) 269-9899

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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 55

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

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1922460955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100275",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100275",
            "telephone_number": "352-273-7839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103220",
            "country_code": "US",
            "telephone_number": "352-273-7839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "GREGORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME151102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.