Olga Fundyler Tate, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

234186 Issued in MA

Practice address

203 Indigo Dr
Brunswick, GA 31525-6865

Phone

(912) 261-2669

NPI assigned

Oct 24, 2007

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

Medicare fee-for-service enrollment

Enrolled in GA, FL, SC3 enrollments

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 3

Specialty

Pathology

Education

University of Arkansas College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Pathology Associates PCGroup PAC ID 5890781371, shared by 2 NPIs, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
• Emory Houston Hospital Warner Robins Hospital, Warner Robins, GA, CCN 110069
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117
• Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: otate744491@direct.shands.ufl.edu

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.

• Southeastern Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Brunswick, GA
  • NPI 1821104704
  Medicare reassignment
• Southeastern Pathology Associates PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Brunswick, GA
  • NPI 1992963268

  FL

  Medicare reassignment
• Coastal Care Inc

  • Primary Care Clinic/Center
  • Waycross, GA
  • NPI 1538367149
  NPD (past)

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

• Houston Hospitals Inc

  • General Acute Care Hospital
  • Perry, GA
  • NPI 1891808499
  Care Compare affiliation
• Houston Hospitals Inc

  • General Acute Care Hospital
  • Warner Robins, GA
  • NPI 1962435792
  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation
• West Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144
  Care Compare affiliation
• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1982883138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 INDIGO DR.",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-261-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 INDIGO DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315256865",
            "telephone_number": "912-261-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "OLGA",
        "middle_name": "FUNDYLER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "234186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wanda Taylor, RN
• Carol Temple, RN
• Karen Jean Terrell, NP-C

• Anatomic Pathology & Clinical Pathology Physician in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.