Individual provider Active NPI

Jeremy M O'Connor, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1164860961
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
292463 Issued in NY
Practice address
1225 Gerard Ave
Bronx, NY 10452-8015
Phone
(718) 960-2777
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 272463 NY
Internal Medicine Physician 207R00000X 55573 CT
Internal Medicine Physician 207R00000X 125062580 IL
Internal Medicine Physician 207R00000X 292463 NY Primary

Addresses

Primary practice location

1225 Gerard Ave
Bronx, NY 10452-8015

Mailing address

1225 Gerard Ave
Bronx, NY 10452-8015
Phone (718) 960-2777

Other identifiers 1

IdentifierTypeStateIssuer
55573OtherCTCT LICENSE NUMBER

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181001001387 NY Practitioner - Internal Medicine 5597980003 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

545 E 142ND St
Bronx, NY 10454-2110
Phone (718) 579-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272463NYMDDermatology Physician
3071CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince Sep 1, 2022 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Current Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Aug 19, 2018 Accepting new patients
New York City Health and Hospitals Corporation Internal Medicine Past Accepting new patients

Locations

545 E 142nd St
Bronx, NY 10454
Phone (718) 579-1719

1225 Gerard Ave
Bronx, NY 10452
Phone (718) 960-2777

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

227 Madison St
New York, NY 10002
Phone (212) 238-7000

227 Madison St
Fl 1
New York, NY 10002
Phone (212) 238-7815

50 Water St
Fl 3
New York, NY 10004

Networks

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

Interoperability endpoints

  • Direct secure messaging: joconnor846223@nychhc.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1164860961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 GERARD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528015",
            "telephone_number": "718-960-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 GERARD AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104528015",
            "telephone_number": "718-960-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JEREMY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "272463",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "55573",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125062580",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "292463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE NUMBER",
            "identifier": "55573",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.