Individual provider Active NPI

James V O'Leary, MD

  • Obstetrics & Gynecology Physician
  • Jacksonville Beach, FL
National Provider Identifier
1245369099
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
36389 Issued in WI
Practice address
1361 13TH Ave S Ste &110&115
Jacksonville Beach, FL 32250-3233
Phone
(904) 247-5514
Fax
(904) 247-3363
NPI assigned
Mar 5, 2007
Last updated
Jul 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 36389 WI Primary

Addresses

Primary practice location

1361 13TH Ave S Ste &110&115
Jacksonville Beach, FL 32250-3233

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Other practice location 1

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 749-4000

Other identifiers 1

IdentifierTypeStateIssuer
32102200MedicaidWI

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
I20200804002784 FL Practitioner - Obstetrics/Gynecology 6305813247 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36389WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Jul 1, 2020 Accepting new patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Jul 1, 2020 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Aug 8, 2020 Accepting new patients
Fox Valley Perinatology, S.C. CurrentSince Aug 1, 2026 Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology Current Accepting new patients
OB Hospitalist Group LLC Obstetrics & Gynecology CurrentSince Aug 8, 2020 Accepting new patients
Women's Care Florida LLC Obstetrics & Gynecology PastSince May 1, 2021 Accepting new patients

Locations

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

8900 SW 88th St
Miami, FL 33176
Phone (305) 596-1960

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1818 N Meade St
Ste 330
Appleton, WI 54911
Phone (920) 749-4000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1245369099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S STE &110&115",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503233",
            "telephone_number": "904-247-5514",
            "fax_number": "904-247-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-749-4000",
            "fax_number": "920-749-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "JAMES",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "36389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32102200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.