MRS. OLIVIA O'MALLEY NP
NPI 1669186615
Nurse Practitioner - Pediatrics in Lake Ronkonkoma, NY

Q: What is Olivia O'malley's NPI number?

The NPI number for Olivia O'malley is 1669186615. It was assigned to this individual provider in the NPPES registry on January 12, 2023.

Q: What is Olivia O'malley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Olivia O'malley was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 12, 2023PECOS Enrolled

6 GLEN DR, LAKE RONKONKOMA, NY 11779(631) 774-9793 Get Directions Write a Review

NPPES record last updated: January 12, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

On this page

About Mrs. Olivia O'malley Np NPPES

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

MRS. OLIVIA O'MALLEY NP (NPI 1669186615) is an individual pediatrics provider in Lake Ronkonkoma, New York, licensed in New York (F383479-01) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669186615

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameMRS. OLIVIA O'MALLEYCredential: NP

Location Address6 GLEN DRLake Ronkonkoma, NY 11779-1506

Mailing Address6 Glen DrLake Ronkonkoma, NY 11779-1506 · (631) 774-9793

Phone(631) 774-9793

Sole ProprietorNo

Enumeration DateJanuary 12, 2023

NPPES CertifiedJanuary 12, 2023

✔ NPI 1669186615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in NY · F383479-01

6 GLEN DR, Lake Ronkonkoma, NY 11779

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Olivia O'malley Np 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.

Medicare Billing Reassignment

Medicare enrollment records show Olivia O'malley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore-Lij Medical PC

32 mi

Urology

1010 NORTHERN BLVD STE 110
Great Neck, NY 11021

Reassigned Medicare billing, New York enrollment
9,353 clinicians in this Medicare group

NPI 1053688572 (516) 321-7400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11779 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$105.06 typical visit price

range $67.40 – $203.53

Typical copayment $26.26 (range $16.85 – $50.88)

Most-billed visit code 99203

Established Patient

$117.62 typical visit price

range $21.66 – $164.45

Typical copayment $29.40 (range $5.41 – $41.11)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olivia O'malley's NPI number?

The NPI number for Olivia O'malley is 1669186615. It was assigned to this individual provider in the NPPES registry on January 12, 2023.

Where is Olivia O'malley located?

Olivia O'malley practices at 6 Glen Dr, Lake Ronkonkoma, NY 11779. The listed phone number is (631) 774-9793.

What is Olivia O'malley's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Olivia O'malley enrolled in Medicare?

Yes. Olivia O'malley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Olivia O'malley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Olivia O'malley reassigns Medicare benefits to North Shore-Lij Medical PC (Great Neck, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Olivia O'malley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Olivia O'malley was last updated on January 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.