Active NPI
Robert Eric Olson, P.A-C
- Physician Assistant
- Marysville, CA
National Provider Identifier
1932147287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17516
- Practice address
- 726 4TH Street
Marysville, CA 94901 - Phone
- (530) 749-4300
- NPI assigned
- Jun 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17516 | CA | Primary |
Addresses
Primary practice location
726 4TH Street
Marysville, CA 94901
Mailing address
2100 Powell Street
Ste. 920
Emeryville, CA 94608-1803
Phone (510) 350-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0PA175160 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041004000368 | CA | Practitioner - Physician Assistant | 1557320868 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Western Sierra Medical Clinic Inc
Practice addresses (Care Compare)
844 Old Tunnel Rd
Grass Valley, CA 95945-8524
Phone (530) 274-9762
Hospital & facility affiliations
- Sierra Nevada Memorial Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17516 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Sierra Medical Clinic, Inc. | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Western Sierra Medical Clinic, Inc. | Past | Accepting new patients |
Locations
1345 Whispering Pines Ln
Grass Valley, CA 95945
Phone (530) 265-7895
844 Old Tunnel Rd
Grass Valley, CA 95945
Phone (530) 273-4984
726 4th St
Marysville, CA 95901
Phone (530) 491-9491
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Interoperability endpoints
- robert.olson@wsmc1.eclinicaldirectplus.com
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- Oregon House, CA
- NPI 1780463257
-
- Federally Qualified Health Center (FQHC)
- Grass Valley, CA
- NPI 1063496396
-
- Federally Qualified Health Center (FQHC)
- Nevada City, CA
- NPI 1427827161
-
- Emergency Medicine Physician
- Red Bluff, CA
- NPI 1548332307
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grass Valley, CA
- NPI 1659361392
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1932147287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL STREET",
"address_2": "STE. 920",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081803",
"telephone_number": "510-350-2600",
"fax_number": "510-879-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "726 4TH STREET",
"city": "MARYSVILLE",
"state": "CA",
"postal_code": "94901",
"telephone_number": "530-749-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "ROBERT",
"middle_name": "ERIC",
"credential": "P.A-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0PA175160",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marysville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.