DR. OLIVIA RENEE SOUDRY MD
NPI 1073372694
Student in an Organized Health Care Education/Training Program in Boston, MA

Q: What is Olivia Soudry's NPI number?

The NPI number for Olivia Soudry is 1073372694. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Q: What is Olivia Soudry's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Olivia Soudry was last updated on March 18, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 18, 2024PECOS Enrolled

720 HARRISON AVE STE 914, BOSTON, MA 02118(617) 638-8540 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Olivia Renee Soudry Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. OLIVIA RENEE SOUDRY MD (NPI 1073372694) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073372694

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. OLIVIA RENEE SOUDRYCredential: MD

Location Address720 HARRISON AVE STE 914Boston, MA 02118-2334

Mailing Address720 Harrison Ave Ste 914Boston, MA 02118-2334 · (617) 638-8540

Phone(617) 638-8540

Sole ProprietorNo

Enumeration DateMarch 18, 2024

NPPES CertifiedMarch 16, 2024

✔ NPI 1073372694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

720 HARRISON AVE STE 914, Boston, MA 02118

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Olivia Renee Soudry Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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