Individual provider Active NPI

Michael Oconnor, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Pinole, CA
National Provider Identifier
1386753317
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
00A446530 Issued in CA
Practice address
1690 San Pablo Ave
Suite F
Pinole, CA 94564-2078
Phone
(925) 753-1986
NPI assigned
Aug 30, 2006
Last updated
Aug 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 00A446530 CA Primary

Addresses

Primary practice location

1690 San Pablo Ave
Suite F
Pinole, CA 94564-2078

Mailing address

1660 San Pablo Ave
Ste a
Pinole, CA 94564-2072
Phone (925) 753-1986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080425000633 CA Practitioner - EndocrinologyPractitioner - Internal Medicine 1759469075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Harvard Medical School, 1984
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1660 San Pablo Ave
Suite a
Pinole, CA 94564-2072

1660 San Pablo Ave a
Pinole, CA 94564-2072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00A446530CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oconnor Physician Group Inc CurrentSince Jun 2, 2010 Accepting new patients
Alta Bates Summit Medical Center Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
California Pacific Medical Group, Inc. Past Accepting new patients
John Muir Health Past Accepting new patients
University of California Irvine Past Accepting new patients
John Muir Health Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1660 San Pablo Ave
Ste A
Pinole, CA 94564
Phone (510) 223-1430

1690 San Pablo Ave
Ste F
Pinole, CA 94564
Phone (510) 724-7644

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1386753317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 SAN PABLO AVE",
            "address_2": "STE A",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642072",
            "telephone_number": "925-753-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 SAN PABLO AVE",
            "address_2": "SUITE F",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642078",
            "telephone_number": "925-753-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "00A446530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.