Individual provider Active NPI

David M O'Neil, MD

  • Gynecology Physician
  • Baltimore, MD
National Provider Identifier
1154364529
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
D0022619 Issued in MD
Practice address
17 Fontana LN
Suite 201
Baltimore, MD 21237-3042
Phone
(410) 391-1000
Fax
(410) 391-0943
NPI assigned
Jun 14, 2006
Last updated
Jul 25, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X D0022619 MD Primary

Addresses

Primary practice location

17 Fontana LN
Suite 201
Baltimore, MD 21237-3042

Mailing address

17 Fontana LN
Suite 201
Baltimore, MD 21237-3042
Phone (410) 391-1000

Other identifiers 1

IdentifierTypeStateIssuer
771421100OtherMDMEDICAL ASSISTANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000497 MD Practitioner - Obstetrics/Gynecology 7214963974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0022619MDMDGynecology Physician

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, 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1154364529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 FONTANA LN",
            "address_2": "SUITE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373042",
            "telephone_number": "410-391-1000",
            "fax_number": "410-391-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 FONTANA LN",
            "address_2": "SUITE 201",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212373042",
            "telephone_number": "410-391-1000",
            "fax_number": "410-391-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEIL",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MD",
            "license": "D0022619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "771421100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.