Innis O'Rourke III, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

151488 Issued in NY

Practice address

3 School St
Suite 101-a
Glen Cove, NY 11542-2548

Phone

(516) 674-2121

Fax

(516) 674-2260

NPI assigned

Jun 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Pediatric Healthcare Solutions, P.C.

  • Pediatrics Physician
  • Glen Cove, NY
  • NPI 1952428823
  Authorized official Same address or phone

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346278215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST",
            "address_2": "SUITE 101-A",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422548",
            "telephone_number": "516-674-2121",
            "fax_number": "516-674-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SCHOOL ST",
            "address_2": "SUITE 101-A",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422548",
            "telephone_number": "516-674-2121",
            "fax_number": "516-674-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "INNIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "151488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00783248",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly O'Boyle
• Joanna O'Brien
• Gail Marjorie O'Dowd, R.N.
• Joanna Tychanska O'Mea, PSY.D.
• Marilyn O'Neill, RPN
• Chantel O'Shea, DO
• Rosemary E Oconnor, LCSW
• Colleen Oliva
• Ophthalmology Associates of Glen Cove, PC
• Marina Orphanides, LMHC

• Pediatrics Physician in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.