Individual provider Active NPI

Sean Raymond O'Connor, PA

  • Physician Assistant
  • Elmira, NY
National Provider Identifier
1083171201
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
027705 Issued in NY
Practice address
600 Roe Ave
Elmira, NY 14905-1676
Phone
(607) 737-4508
Fax
(607) 735-5738
NPI assigned
Feb 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 027705 NY Primary

Addresses

Primary practice location

600 Roe Ave
Elmira, NY 14905-1676

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (072) 712-0506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220128000523 NY Practitioner - Physician Assistant 7113269168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians

Practice addresses (Care Compare)

600 Roe Ave
Elmira, NY 14905-1629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
46.76
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56591CAMDDentist
027705NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center CurrentSince Apr 3, 2023 Accepting new patients
Arnot Ogden Medical Center CurrentSince Apr 3, 2023 Accepting new patients
Arnot Medical Services PLLC CurrentSince Mar 5, 2023 Accepting new patients

Locations

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

571 Saint Josephs Blvd
Fl 2
Elmira, NY 14901
Phone (607) 271-2050

Interoperability endpoints

  • Direct secure messaging: soconnor26732@direct.xtensys.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1550966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1083171201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "072-712-0506",
            "fax_number": "607-873-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051676",
            "telephone_number": "607-737-4508",
            "fax_number": "607-735-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "SEAN",
        "middle_name": "RAYMOND",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-24",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "027705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.