Individual provider Active NPI

Patricia Ann O'Neill, APRN

  • Adult Health Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1073547568
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
000873 Issued in CT
Practice address
226 Mill Hill Ave
3Rd Floor
Bridgeport, CT 06610-2826
Phone
(203) 384-3394
Fax
(203) 384-3829
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 000873 CT Primary

Addresses

Primary practice location

226 Mill Hill Ave
3Rd Floor
Bridgeport, CT 06610-2826

Mailing address

PO Box 415126
Boston, MA 02241-5126
Phone (203) 384-3975

Other identifiers 1

IdentifierTypeStateIssuer
000873OtherCTLISCENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100129000472 CT Practitioner - Nurse Practitioner 8123161130 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000873CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jun 19, 2011 Accepting new patients
Yale University CurrentSince Jun 19, 2011 Accepting new patients

Locations

226 Mill Hill Ave
Ste 3
Bridgeport, CT 06610
Phone (203) 384-3394

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

Interoperability endpoints

  • Direct secure messaging: poneill10607@direct.ynhh.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1073547568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415126",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415126",
            "telephone_number": "203-384-3975",
            "fax_number": "203-384-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 MILL HILL AVE",
            "address_2": "3RD FLOOR",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066102826",
            "telephone_number": "203-384-3394",
            "fax_number": "203-384-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "000873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE",
            "identifier": "000873",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.