Kevin William O'Connell

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

325 Cedar Ridge Dr
Glastonbury, CT 06033-1817

Phone

(860) 930-3053

NPI assigned

Oct 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: koconnell@montefioredirect.com

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• CHS Physician Partners, PC

  • Interventional Cardiology Physician
  • Fresh Meadows, NY
  • NPI 1407089345
  Medicare reassignment
• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD
• CHS Physician Partners, PC

  • Family Medicine Physician
  • Bellmore, NY
  • NPI 1720334527
  NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1104469477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CEDAR RIDGE DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331817",
            "telephone_number": "860-930-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CEDAR RIDGE DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331817",
            "telephone_number": "860-930-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "KEVIN",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guljan Nurmuradova
• Nutrition and Wellness Consulting, LLC
• Therese McConnell Nuzzolo, RDN
• Gillian Mary O'Callaghan, APRN
• Kelly O'Connell-Seagraves, LPC
• Terry Saphr O'Donnell, PA
• Lauren A O'Leary, LPC
• Kerry K O'Neal, OD
• Margaret Ryan O'Neill, MD
• James Joseph Ocampo, MD

• Physician Assistant in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.