Individual provider Active NPI

Catherine M O'Brien, FNP

  • Family Nurse Practitioner
  • Watertown, NY
National Provider Identifier
1154330751
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F332600-1 Issued in NY
Practice address
26495 State Route 3
Watertown, NY 13601-1749
Phone
(315) 786-1924
Fax
(315) 786-0823
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F332600-1 NY Primary

Addresses

Primary practice location

26495 State Route 3
Watertown, NY 13601-1749

Mailing address

PO Box 8009
Watertown, NY 13601-8009
Phone (315) 786-1924

Other identifiers 1

IdentifierTypeStateIssuer
02011310MedicaidNY

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
I20040720000226 NY Practitioner - Nurse Practitioner 7618956954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Nurse Practitioners-Family Health PLLCGroup PAC ID 2668451998, 5 clinicians

Practice addresses (Care Compare)

19472 US Route 11
Watertown, NY 13601-6897
Phone (315) 786-1924

Hospital & facility affiliations

  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Samaritan Medical Center Hospital, Watertown, NY, CCN 330157

Merit-based Incentive Payment System (MIPS)

Final score
87.13 of 100Reported as group
Quality
74.26
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F332600-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Nurse Practitioners - Family Health PLLC Family CurrentSince May 17, 2004 Accepting new patients
Eye Plastic and Reconstructive Surgery of Cny PC Past Accepting new patients
Rachel E. Lewis M.D. Past Accepting new patients

Locations

19472 US Route 11
Watertown, NY 13601
Phone (315) 782-6126

19472 US Route 11
Ste N101
Watertown, NY 13601
Phone (315) 422-3937

26495 State Route 3
Watertown, NY 13601
Phone (315) 782-0002

Organizations & group practices 3

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 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1154330751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8009",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136018009",
            "telephone_number": "315-786-1924",
            "fax_number": "315-786-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26495 STATE ROUTE 3",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011749",
            "telephone_number": "315-786-1924",
            "fax_number": "315-786-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "CATHERINE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F332600-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02011310",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.