Individual provider Active NPI

Matthew Alan O'Connor, CRNA

  • Certified Registered Nurse Anesthetist
  • Glasgow, KY
National Provider Identifier
1164608147
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
45412 Issued in KY
Practice address
1301 N Race St
Glasgow, KY 42141-3483
Phone
(270) 651-4134
Fax
(270) 651-4234
NPI assigned
Jan 21, 2008
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 45412 KY Primary

Addresses

Primary practice location

1301 N Race St
Glasgow, KY 42141-3483

Mailing address

1301 N Race St
Glasgow, KY 42141-3483
Phone (270) 651-4134

Other identifiers 1

IdentifierTypeStateIssuer
7100032700MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN, NH3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20080215000066 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678656527 Reassigns benefits to 3 organizations
I20081001000284 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678656527 Reassigns benefits to 1 organization
I20221024000647 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678656527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag Anesthesia PLLCGroup PAC ID 1759375983, 165 clinicians
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-2431

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
45412KYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amoskeag Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2022 Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2021 Accepting new patients
T J Samson Community Hospital Nurse Anesthetist, Certified Registered CurrentSince May 10, 2021 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
Radius Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2025 Accepting new patients
Kentucky Anesthesia Partners PLLC CurrentSince Sep 1, 2025 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
Anesthesia & Pain Specialists of Bowling Green PLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

828 Lane Allen Rd
Ste 219
Lexington, KY 40504

9900 Corporate Campus Dr
Ste 3000
Louisville, KY 40223
Phone (502) 657-6013

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

1 Elliot Way
Ste 200
Manchester, NH 03103
Phone (603) 623-4640

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

110 29th Ave N
Ste 202
Nashville, TN 37203
Phone (615) 327-7870

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1164608147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413483",
            "telephone_number": "270-651-4134",
            "fax_number": "270-651-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N RACE ST",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421413483",
            "telephone_number": "270-651-4134",
            "fax_number": "270-651-4234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MATTHEW",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "45412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100032700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.