Individual provider Active NPI

Ellen J O'Connell, MD

  • Emergency Medicine Physician
  • Lewisville, TX
National Provider Identifier
1063440121
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L9831 Issued in TX
Practice address
500 W Main St
Lewisville, TX 75057-3629
Phone
(972) 420-1576
NPI assigned
Jun 29, 2006
Last updated
Oct 4, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L9831 TX Primary

Addresses

Primary practice location

500 W Main St
Lewisville, TX 75057-3629

Mailing address

4034 Rawlins St Apt 106
Dallas, TX 75219-5632
Phone (214) 252-0490

Other identifiers 2

IdentifierTypeStateIssuer
8C0848OtherTXBCBS
P00399314OtherTXRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050622000848 TX Practitioner - Emergency Medicine 3274578075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Emergency Medicine CurrentSince Jul 1, 2005 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2005 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1063440121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4034 RAWLINS ST APT 106",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752195632",
            "telephone_number": "214-252-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750573629",
            "telephone_number": "972-420-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "ELLEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L9831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8C0848",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00399314",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.