Individual provider Active NPI

John J Obrien Jr., MD

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • St Petersburg, FL
National Provider Identifier
1255445862
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X
License
ME0066063 Issued in FL
Practice address
7855 38TH Ave N
St Petersburg, FL 33710-1134
Phone
(727) 341-2408
Fax
(727) 341-2708
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician 2082S0099X ME0066063 FL Primary

Addresses

Primary practice location

7855 38TH Ave N
St Petersburg, FL 33710-1134

Mailing address

7855 38TH Ave N
St Petersburg, FL 33710-1134
Phone (727) 341-2408

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
I20040429000339 FL Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 6305833518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Hand Surgery
Education
State University of New York at Buffalo School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7855 - 38TH Ave N
St. Petersburg, FL 33710-1152

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0066063FLMDPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John J. O'Brien, Jr., M.D., P.a. CurrentSince Apr 16, 1994 Accepting new patients

Locations

7855 38th Ave N
St Petersburg, FL 33710
Phone (727) 341-2408

Organizations & group practices 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255445862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101134",
            "telephone_number": "727-341-2408",
            "fax_number": "727-341-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 38TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101134",
            "telephone_number": "727-341-2408",
            "fax_number": "727-341-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "FL",
            "license": "ME0066063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.