Individual provider Active NPI

Bonnie O Oconnor, PA C

  • Surgical Physician Assistant
  • Newark, DE
National Provider Identifier
1033199948
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713
Phone
(302) 731-2888
Fax
(302) 731-7049
NPI assigned
Jan 18, 2006
Last updated
Apr 28, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C50000144 DE
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713

Mailing address

4745 Ogletown Stanton Rd
Suite 225
Newark, DE 19713
Phone (302) 731-2888

Other identifiers 1

IdentifierTypeStateIssuer
0000499843MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100422000148 DE Practitioner - Physician Assistant 0446307839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First State Orthopaedics PAGroup PAC ID 6103800057, 97 clinicians

Practice addresses (Care Compare)

4102 Ogletown Stanton Rd
Suite B
Newark, DE 19713-4183
Phone (302) 731-2888

4745 Ogletown Stanton Rd
Newark, DE 19713-2074
Phone (302) 731-2888

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
96
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C50000144DEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
First State Orthopaedics, PA CurrentSince Sep 16, 1993 Accepting new patients
Spine Care Delaware, LLC Current Accepting new patients
First State Orthopaedics PA CurrentSince Sep 16, 1993 Accepting new patients

Locations

211 Executive Dr
Ste 11
Newark, DE 19702
Phone (302) 793-1800

4102 Stanton Ogletown Rd
Ste B
Newark, DE 19713
Phone (302) 894-1800

4106 Ogletown Stanton Rd
Newark, DE 19713
Phone (302) 894-1600

4745 Ogletown Stanton Rd
Ste 238
Newark, DE 19713

4745 Stanton Ogletown Rd
Ste 225
Newark, DE 19713
Phone 30273128881001

Interoperability endpoints

  • Direct secure messaging: bonnie.oconnorpac.p1@direct.fsoortho.nextgenshare.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1033199948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 225",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 OGLETOWN STANTON RD",
            "address_2": "SUITE 225",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-731-2888",
            "fax_number": "302-731-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "BONNIE",
        "middle_name": "O",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50000144",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000499843",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.