OLIVIA WHEATLEY – Physician Assistant, NPI 1154082121

OLIVIA WHEATLEY is a healthcare provider. based in South lake tahoe, California. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA2921 (NV). The NPI Number for OLIVIA WHEATLEY is 1154082121

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
OLIVIA WHEATLEY
NPI
1154082121
Phone
Not provided
Address
1114 MODOC WAY
Enumeration Date
3 January 2022
Last Update Date
30 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7754457170
Graduation Year
2023 (3 years ago)
PAC ID
5698114320
Group Practice PAC ID
1153479027
Professional Enrollment ID
I20240415002328
Address ID
NV897061682CA2874XSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

10,564 PHYSICIAN ASSISTANT in CA

Provider Addresses for OLIVIA WHEATLEY

  • 1114 MODOC WAY

    SOUTH LAKE TAHOE, CA 961505248

    Phone:

    Type: Mailing

  • 2874 N CARSON ST STE 120

    CARSON CITY, NV 897061681

    Phone: (775) 445-5193

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $203.

Total Amount is formed as General ($203) + Research ($0) + Ownership ($0) = $203.

Last reported payment date: 2024-12-03 • Largest payer in this snapshot: Mannkind Corporation ($78).

Total Amount

$203

General + Research + Ownership

Payments

6

Total payment records

General Amount

$203

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-03

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240415002328IPhysician AssistantNVTBD
I20260309000978IPhysician AssistantCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96150)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153479027View full group profile
NameSpecialtyState
Internal Medicine, Cardiovascular Disease (Cardiology)NV
-NV
U R O L O G YCA
Cardiovascular Disease (Cardiology), Internal MedicineNV
-NV
Family PracticeNV
Physician AssistantNV
Physician AssistantMT
-NV
-NV

Reviews

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Frequently asked questions

What is the 10-digit NPI for OLIVIA WHEATLEY?
OLIVIA WHEATLEY — NPI 1154082121 — is the standard way to identify this listing.
Can I rely on OLIVIA WHEATLEY being an active provider?
As of the registry snapshot, OLIVIA WHEATLEY is marked active.
What is OLIVIA WHEATLEY best known for clinically?
Directory data describes OLIVIA WHEATLEY with Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for OLIVIA WHEATLEY?
OLIVIA WHEATLEY's geographic hint is South Lake Tahoe, California in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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