Lisa O'Connor, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

264787 Issued in NY

Practice address

301 Prospect Ave
Inpatient Mental Health
Syracuse, NY 13203-1807

Phone

(315) 448-5360

Fax

(315) 448-6137

NPI assigned

Jun 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• St. Joseph's Physician Health, P.C.

  • Anesthesiology Physician
  • Troy, NY
  • NPI 1154376770
  NPD (past)

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

{
    "created_epoch": "1214092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365120000000",
    "number": "1316108384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "INPATIENT MENTAL HEALTH",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5360",
            "fax_number": "315-448-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PROSPECT AVE",
            "address_2": "INPATIENT MENTAL HEALTH",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132031807",
            "telephone_number": "315-448-5360",
            "fax_number": "315-448-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-22",
        "last_updated": "2013-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "264787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03470606",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Watley O'Connor, MS,CCC-SLP
• Christine O'Connor
• James Thomas O'Connor, PA-C
• Jennifer O'Connor
• Kevin O'Connor, M.D.
• Lisa Marie O'Connor, RPA-C
• Matthew Crosby O'Connor, M.D.
• Taylor Lisette O'Connor, P-MHC
• Victoria M O'Connor, P.T.
• Brendan O'Donnell, ATC

• Psychiatry Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.