Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Patrick Olise, PA

Individual provider Physician Assistant · NPI 1770990848

Patrick Olise, PA is a Physician Assistant in Marietta, Georgia. Qualified in 2014, 12 years ago. Practices with San Juan Regional Medical Center, Inc, a 231-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia and New Mexico.

Years since qualifying
12
Licensed in
GA, NM
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

55 Whitcher St NE Ste 160
Marietta, GA 30060-1160
Phone: (770) 422-1372
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 630 W Maple St, Farmington, NM 87401-6113 — (505) 609-6349

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7242 (GA)
Physician Assistant Taxonomy 363A00000X · Licence PA2016-0024 (NM)

Record details

NPI number1770990848
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 21, 2014
Last updated in NPPESNovember 12, 2024
Certification dateNovember 12, 2024
Mailing addressPo Box 844088, Dallas, TX 75284-4088

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice San Juan Regional Medical Center, Inc. — 231 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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