Individual provider Active NPI

Victoria Jeanne O'Brien, DO

  • Obstetrics & Gynecology Physician
  • Fort Drum, NY
National Provider Identifier
1275023855
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
329021 Issued in NY
Practice address
USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5001
Phone
(315) 785-4624
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 010220592 VA
Obstetrics & Gynecology Physician 207V00000X 9871946 ID
Obstetrics & Gynecology Physician 207V00000X 329021 NY Primary

Addresses

Primary practice location

USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5001

Mailing address

USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602-5001
Phone (315) 785-4624

Other practice location 1

1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-6621

Other practice location 2

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 302-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240726001757 NY Practitioner - Obstetrics/Gynecology 9032655956 Reassigns benefits to 3 organizations
I20250428002276 ID Practitioner - Obstetrics/Gynecology 9032655956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

1072 N Liberty St
Boise, ID 83704-8708

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
329021NYMDLicensed Practical Nurse
010220592VAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 1, 2025 Accepting new patients
St. Joseph's Pathology, PC Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Apr 1, 2025 Accepting new patients
St Josephs Hospital Health Center CurrentSince Mar 1, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jul 13, 2024 Accepting new patients
St Joseph's Hospital Health Center Obstetrics & Gynecology CurrentSince Mar 1, 2025 Accepting new patients
Canton-Potsdam Hospital CurrentSince Jul 13, 2024 Accepting new patients
University OB/GYN Associates Obstetrics & Gynecology CurrentSince Apr 1, 2025 Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

90 Presidential Plz
Fl 1
Syracuse, NY 13202
Phone (315) 464-5210

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

301 Prospect Ave
Ste 706
Syracuse, NY 13203
Phone (315) 703-5200

725 Irving Ave
Ste 600
Syracuse, NY 13210
Phone (315) 464-5162

Interoperability endpoints

  • Direct secure messaging: vobrien4060553@direct.trinity-health.org

Organizations & group practices 8

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": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1275023855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025001",
            "telephone_number": "315-785-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025001",
            "telephone_number": "315-785-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Army Medical Center",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-6621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-302-1200",
            "fax_number": "208-302-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "VICTORIA",
        "middle_name": "JEANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "010220592",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "9871946",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "329021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

Verify at the official NPI Registry.