NPIMap

Individual provider Active NPI

Kevin M O'Hara, PA

  • Medical Physician Assistant
  • New Haven, CT
National Provider Identifier
1235463522
Registry record updated Dec 16, 2014
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Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003167 Issued in CT
Practice address
1450 Chapel St
New Haven, CT 06511-4405
Phone
(203) 737-1003
NPI assigned
Sep 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003167 CT Primary

Addresses

Primary practice location

1450 Chapel St
New Haven, CT 06511-4405

Mailing address

PO Box 208083
New Haven, CT 06520-8083
Phone (203) 737-1003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918000933 NY Practitioner - Physician Assistant 5698090371 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MSK NassauGroup PAC ID 8628311685, 100 clinicians
Memorial Hematology Lymphoma GroupGroup PAC ID 7113816489, 215 clinicians
Mskcc Regional NetworkGroup PAC ID 6608765144, 130 clinicians

Practice addresses (Care Compare)

1101 Hempstead Tpke
Uniondale, NY 11553-1112
Phone (212) 639-2000

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

530 E 74TH St
New York, NY 10021-3402
Phone (212) 639-2000

650 Commack Rd
Commack, NY 11725-5404
Phone (631) 623-4034

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
77.63 of 100Reported as group
Quality
66.91
Improvement activities
40
Cost
71.93

Merit-based Incentive Payment System (MIPS)

Final score
79.57 of 100Reported as group
Quality
70.48
Improvement activities
40
Cost
69.36

Merit-based Incentive Payment System (MIPS)

Final score
80.82 of 100Reported as group
Quality
71.2
Improvement activities
40
Cost
72.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3167CTMDProfessional Counselor
003167CTMDMedical Physician Assistant

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
Mskcc Clinical Practice Plan CurrentSince Jul 24, 2018 Accepting new patients

Locations

650 Commack Rd
Commack, NY 11725
Phone (631) 623-4000

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

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

Interoperability endpoints

  • Direct secure messaging: kohara22902@mskcc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1253404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1235463522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 208083",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208083",
            "telephone_number": "203-737-1003",
            "fax_number": "203-785-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-737-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-20",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "003167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.