Individual provider Active NPI

Nicholas J Connors, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1194723643
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
ME0067867 Issued in FL
Practice address
1641 Tamiami TRL
Suite 1
Port Charlotte, FL 33948-1042
Phone
(941) 629-6262
Fax
(941) 629-1782
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME67867 FL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X ME0067867 FL Primary

Addresses

Primary practice location

1641 Tamiami TRL
Suite 1
Port Charlotte, FL 33948-1042

Mailing address

1641 Tamiami TRL
Suite 1
Port Charlotte, FL 33948-1042
Phone (941) 629-6262

Other identifiers 2

IdentifierTypeStateIssuer
257697000MedicaidFL
68789OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100212000501 FL Practitioner - Orthopedic Surgery 7012913783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME67867FLMDOrthopaedic Surgery Physician
ME0067867FLMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedic Center of Charlotte County, PA Orthopaedic Surgery CurrentSince Nov 1, 1999 Accepting new patients
Advanced Orthopedic Center of Charlotte County, PA Orthopaedic Surgery CurrentSince Nov 1, 1999 Accepting new patients

Locations

1641 Tamiami Trl
Pt Charlotte, FL 33948
Phone (941) 629-6262

1641 Tamiami Trl
Ste 1
Pt Charlotte, FL 33948
Phone (941) 629-6262

350 Mary St
Ste F
Punta Gorda, FL 33950
Phone (941) 629-6262

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nconnors@aocc1855.srs-direct.com
  • Direct secure messaging: nconnors@aoc.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1194723643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 TAMIAMI TRL",
            "address_2": "SUITE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481042",
            "telephone_number": "941-629-6262",
            "fax_number": "941-629-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 TAMIAMI TRL",
            "address_2": "SUITE 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481042",
            "telephone_number": "941-629-6262",
            "fax_number": "941-629-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNORS",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME67867",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0067867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257697000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "68789",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.