Individual provider Active NPI

John Peter O'Brien, MD.

  • Family Medicine Physician
  • Cazenoviz, NY
National Provider Identifier
1013123579
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
243461 Issued in NY
Practice address
132 1/2 Albany Street
Cazenoviz, NY 13035
Phone
(315) 655-8171
Fax
(315) 655-5923
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 243461 NY Primary
Obstetrics Physician 207VX0000X 243461 NY

Addresses

Primary practice location

132 1/2 Albany Street
Cazenoviz, NY 13035

Mailing address

5112 West Taft Road
Suite L
Liverpool, NY 13088
Phone (315) 452-2500

Other identifiers 1

IdentifierTypeStateIssuer
02889572MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071022000383 NY Practitioner - Family Practice 6406942424 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Josephs Medical PC 388 clinicians
St Josephs Hospital Health Center 107 clinicians

Practice addresses (Care Compare)

301 Prospect Ave
Syracuse, NY 13203-1807
Phone (315) 448-5111

4101 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 637-7878

4103 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1500

4117 Medical Ctr Dr
Fayetteville, NY 13066-6600
Phone (315) 744-1551

5100 W Taft Rd
Liverpool, NY 13088-4841

Hospital & facility affiliations

  • HCR Home Care Home health agency, East Syracuse, NY, CCN 337119
  • St Joseph'S Hospital Health Center Hospital, Syracuse, NY, CCN 330140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
243461NYMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Physician Health, P.C. Family Medicine CurrentSince Jul 1, 2008 Accepting new patients
North Medical PC Family Medicine Current Accepting new patients
St. Joseph'S Pathology, PC Current Accepting new patients
St Josephs Hospital Health Center CurrentSince Jan 14, 2010 Accepting new patients
St Josephs Medical PC Family Medicine CurrentSince Jan 1, 2014 Accepting new patients
St Joseph'S Hospital Health Center Family Medicine CurrentSince Jan 14, 2010 Accepting new patients
Verona Family Practice Family Medicine Past Accepting new patients

Locations

132 Albany St
Ste 12
Cazenovia, NY 13035
Phone (315) 655-3668

5112 W Taft Rd
Ste L
Liverpool, NY 13088

5100 W Taft Rd
Ste 2T
Liverpool, NY 13088
Phone (315) 744-1592

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

104 Union Ave
Syracuse, NY 13203
Phone (315) 422-4442

301 Prospect Ave
Rm 1605
Syracuse, NY 13203

Interoperability endpoints

  • Direct secure messaging: jobrien2389977@direct.trinity-health.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1013123579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 WEST TAFT ROAD",
            "address_2": "SUITE L",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "13088",
            "telephone_number": "315-452-2500",
            "fax_number": "315-452-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 1/2 ALBANY STREET",
            "city": "CAZENOVIZ",
            "state": "NY",
            "postal_code": "13035",
            "telephone_number": "315-655-8171",
            "fax_number": "315-655-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JOHN",
        "middle_name": "PETER",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "243461",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "243461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02889572",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cazenoviz, NY

Sources for this page

Verify at the official NPI Registry.