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DR. OCTAVIO OLIVAS JR. DO, MPH
NPI 1831931773
Student in an Organized Health Care Education/Training Program in Flagstaff, AZ

Active since June 11, 2024PECOS Enrolled
2920 N 4TH ST, FLAGSTAFF, AZ 86004(928) 522-9400 Get Directions Write a Review

NPPES record last updated: July 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 5, 2024, Jun 11, 2024 (2 updates tracked since 2024).

About Dr. Octavio Olivas Jr. Do, Mph NPPES

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

DR. OCTAVIO OLIVAS JR. DO, MPH (NPI 1831931773) is an individual student in an organized health care education/training program in Flagstaff, Arizona, licensed in Arizona (R4464) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831931773
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. OCTAVIO OLIVAS JR.Credential: DO, MPH
Location Address2920 N 4TH STFlagstaff, AZ 86004-1816
Mailing Address2920 N 4th StFlagstaff, AZ 86004-1816
Phone(928) 522-9400
Sole ProprietorNo
Enumeration DateJune 11, 2024
Last NPPES UpdateJuly 5, 20242 updates tracked since enumeration
NPPES CertifiedJuly 5, 2024
✔ NPI 1831931773 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
License✔ Licensed in AZ · R4464
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.
2920 N 4TH ST, Flagstaff, AZ 86004
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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. Octavio Olivas Jr. Do, Mph 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DUNYA COPE LPC
Counselor (Professional)
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
CHLOE STRIKE RDH
Dental Hygienist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
KARIS HINAE JO YUN CHOY
Pharmacist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
DR. JORDAN MICHAEL HAHN PHARMD
Pharmacist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
DR. JOHN PAUL GRAZIANO M.D.
Obstetrics & Gynecology
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400
KATRINA MIKITIK RN
Registered Nurse
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 864-9374
EMILY H NIETO DMD, MPH
Dentist
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9405
KATRINA BURLEIGH WILSON DO
Obstetrics & Gynecology
2920 N 4TH ST
FLAGSTAFF, AZ 86004
Coconino County (928) 522-9400

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 Octavio Olivas's NPI number?

The NPI number for Octavio Olivas is 1831931773. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Where is Octavio Olivas located?

Octavio Olivas practices at 2920 N 4th St, Flagstaff, AZ 86004. The listed phone number is (928) 522-9400.

What is Octavio Olivas's specialty?

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

Is Octavio Olivas enrolled in Medicare?

Yes. Octavio Olivas is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Octavio Olivas was last updated on July 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.