Brendan O'Neill, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

49416 Issued in AZ

Practice address

1490 N Turquoise Dr
Flagstaff, AZ 86001-1383

Phone

(928) 774-5074

Fax

(928) 779-0884

NPI assigned

Jul 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS), Pathology

Education

Drexel University College of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Arizona Dermatology Center PCGroup PAC ID 8527951052, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.87 of 100Reported as individual

Quality

77.95

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: boneill@naznew.emadirect.md

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.

• Northern Arizona Dermatology Center PC

  • Dermatology Physician
  • Flagstaff, AZ
  • NPI 1962558569
  Medicare reassignment Care Compare group NPD
• Northern Arizona Dermatology Center PC

  • Dermatology Physician
  • Flagstaff, AZ
  • NPI 1477748069
  NPD
• Northern Arizona Dermatology Center PC

  • Dermatology Physician
  • Cottonwood, AZ
  • NPI 1922293349
  NPD
• Northern Arizona Dermatology Center, PC

  • Procedural Dermatology Physician
  • Page, AZ
  • NPI 1003112327
  NPD (past)

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1013170695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 N TURQUOISE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011383",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 N TURQUOISE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011383",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "BRENDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "50202",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "AZ",
            "license": "49416",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AZ",
            "license": "49416",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD450182",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "49416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920324",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "boneill@naznew.emadirect.md",
            "affiliation": "Y",
            "endpointDescription": "Modernizing Medicine",
            "affiliationName": "Northern Arizona Dermatology Center PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1490 N Turquoise Dr",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860011383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sherry O'Brien, NURSE PRACTITIONER
• Claire O'Connell
• Rachel Michelle O'Connor, D.P.M.
• Kelly Marie O'Donnell, LCSW
• Meghan O'Donnell, MD
• Mary Patricia O'Neill, PH.D.
• Carol L. O'Saben, LP
• John O'Shea, PA-C
• Oasis Dental Care, Inc.
• Oasis Dental Care, Inc.

• Dermatology Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.