Individual provider Active NPI

Brenda Oconnell, P.T.

  • Physical Therapist
  • Plymouth, MA
National Provider Identifier
1114935921
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3086 Issued in MA
Practice address
45 Resnik Rd Ste 104a
Plymouth, MA 02360-4843
Phone
(781) 934-7292
Fax
(781) 934-8112
NPI assigned
Aug 4, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3086 MA Primary

Addresses

Primary practice location

45 Resnik Rd Ste 104a
Plymouth, MA 02360-4843

Mailing address

46 Tara Dr
Pembroke, MA 02359-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060504000393 MA Practitioner - Physical Therapist in Private Practice 2860402898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

45 Resnik Rd
Suite 104a
Plymouth, MA 02360-4843
Phone (508) 747-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3086MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Rehabilitation Network LLC Physical Therapist CurrentSince Dec 30, 2019 Accepting new patients
Pinnacle Rehabilitation Network LLC Physical Therapist CurrentSince Dec 30, 2019 Accepting new patients

Locations

45 Resnik Rd
Plymouth, MA 02360
Phone (508) 746-0754

45 Resnik Rd
Ste 104A
Plymouth, MA 02360
Phone (508) 747-6600

73 Newton Rd
Unit 101
Plaistow, NH 03865
Phone (978) 388-7272

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, 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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1114935921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 TARA DR",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023592625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RESNIK RD STE 104A",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604843",
            "telephone_number": "781-934-7292",
            "fax_number": "781-934-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNELL",
        "first_name": "BRENDA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "3086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.