Organization Active NPI

Patrick T Oconnell Psy D PA

  • Clinical Psychologist
  • Clearwater, FL
National Provider Identifier
1225211873
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY5391 Issued in FL
Legal business name
PATRICK T OCONNELL PSY D PA
Practice address
13575 58TH St N
Suite 119
Clearwater, FL 33760-3740
Phone
(727) 538-7714
Fax
(727) 799-0191
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Authorized official

Name
Patrick T Oconnell, PSY DNPI 1770659682
Title
Clinical Psychologist
Phone
(727) 538-7714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PY5391 FL Primary

Addresses

Primary practice location

13575 58TH St N
Suite 119
Clearwater, FL 33760-3740

Mailing address

13575 58TH St N
Suite 119
Clearwater, FL 33760-3740
Phone (727) 538-7714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041028000508 FL Part B Supplier - Clinic/Group Practice 9032171434 Receives reassigned benefits from 1 practitioner
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

13575 58th St N
Ste 119
Clearwater, FL 33760
Phone (727) 538-7714

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1225211873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13575 58TH ST N",
            "address_2": "SUITE 119",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603740",
            "telephone_number": "727-538-7714",
            "fax_number": "727-799-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13575 58TH ST N",
            "address_2": "SUITE 119",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603740",
            "telephone_number": "727-538-7714",
            "fax_number": "727-799-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK T OCONNELL PSY D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "OCONNELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "727-538-7714",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY5391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.