NPIMap

Individual provider Active NPI

Devlin O'Connor, D.O.

  • Family Medicine Physician
  • Tavares, FL
National Provider Identifier
1053759035
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS15123 Issued in FL
Practice address
3330 Waterman Way
Tavares, FL 32778-5250
Phone
(352) 343-0181
Fax
(352) 343-0812
NPI assigned
Jun 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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 5315059352 MI
Family Medicine Physician 207Q00000X OS15123 FL Primary

Addresses

Primary practice location

3330 Waterman Way
Tavares, FL 32778-5250

Mailing address

3330 Waterman Way
Tavares, FL 32778-5250
Phone (352) 343-0181

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (248) 888-2516

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180427001127 FL Practitioner - Family Practice 2365741105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

19735 US Hwy 441
FL 1
Mount Dora, FL 32757-2204
Phone (352) 735-5700

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS15123FLMDFamily Medicine Physician
5315059352MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Apr 16, 2018 Accepting new patients
Florida Hospital Medical Group Inc Family Medicine CurrentSince Apr 16, 2018 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

19735 US Highway 441
Fl 1
Mount Dora, FL 32757
Phone (352) 735-5700

3330 Waterman Way
Tavares, FL 32778
Phone (352) 385-3022

1749 David Walker Dr
Tavares, FL 32778
Phone (352) 742-1760

Interoperability endpoints

  • Direct secure messaging: doconnor71354@adventhealth.direct-ci.com

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1053759035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-343-0181",
            "fax_number": "352-343-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785250",
            "telephone_number": "352-343-0181",
            "fax_number": "352-343-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-888-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "DEVLIN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5315059352",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.