Individual provider Active NPI

Daniel L O'Donoghue, PA.C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1285670620
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
876 Issued in OK
Practice address
900 NE 10TH St
Oklahoma City, OK 73104-5420
Phone
(405) 271-4311
NPI assigned
Jun 22, 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
Physician Assistant 363A00000X 876 OK Primary

Addresses

Primary practice location

900 NE 10TH St
Oklahoma City, OK 73104-5420

Mailing address

1122 NE 13TH St
Ori236
Oklahoma City, OK 73117-1039
Phone (405) 271-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061005000252 OK Practitioner - Physician Assistant 1850395203 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
876OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Mar 1, 2007 Accepting new patients
Board of Regents of the University of Oklahoma - Ou Physicians CurrentSince Mar 1, 2007 Accepting new patients

Locations

825 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-1500

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

825 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-4864

Organizations & group practices 2

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285670620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 NE 13TH ST",
            "address_2": "ORI236",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171039",
            "telephone_number": "405-271-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 NE 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045420",
            "telephone_number": "405-271-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONOGHUE",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "PA.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.