Individual provider Active NPI

Karen Olmo, PA

  • Physician Assistant
  • Portsmouth, VA
National Provider Identifier
1992243646
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110005493 Issued in VA
Practice address
3315 High St
Portsmouth, VA 23707-3319
Phone
(757) 399-0759
Fax
(757) 397-5368
NPI assigned
Feb 2, 2017
Last updated
Feb 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110005493 VA Primary

Addresses

Primary practice location

3315 High St
Portsmouth, VA 23707-3319

Mailing address

3315 High St
Portsmouth, VA 23707-3319
Phone (757) 399-0759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170410000548 VA Practitioner - Physician Assistant 6800172669 Reassigns benefits to 1 organization
I20190711000709 DC Practitioner - Physician Assistant 6800172669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Arun K Gupta PCGroup PAC ID 5294714044, 4 clinicians

Practice addresses (Care Compare)

9306 Forest Point Cir
Manassas, VA 20110-4700
Phone (703) 330-3322

9306 Forest Point Circle
Manassas, VA 20110-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110005493VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Manassas Primary Care, LLC PastSince Sep 4, 2011 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1992243646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073319",
            "telephone_number": "757-399-0759",
            "fax_number": "757-397-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073319",
            "telephone_number": "757-399-0759",
            "fax_number": "757-397-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLMO",
        "first_name": "KAREN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110005493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.