Individual provider Active NPI

Marykate O'Brien, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1396300430
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
7068 Issued in NC
Practice address
1126 N Church St Ste 201
Greensboro, NC 27401-1036
Phone
(336) 235-0866
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 7068 NC Primary

Addresses

Primary practice location

1126 N Church St Ste 201
Greensboro, NC 27401-1036

Mailing address

1126 N Church St Ste 201
Greensboro, NC 27401-1036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, ME, CT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190827001264 NC Practitioner - Physician Assistant 5496083610 Reassigns benefits to 1 organization
I20220324001988 ME Practitioner - Physician Assistant 5496083610 Reassigns benefits to 1 organization
I20250724000768 CT Practitioner - Physician Assistant 5496083610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

40 Temple St
New Haven, CT 06510-2715

6 Devine St
North Haven, CT 06473-2195
Phone (203) 287-6100

800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7068NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jun 26, 2025 Accepting new patients
Yale University CurrentSince Jun 26, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince May 22, 2022 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

489 State St
Bangor, ME 04401
Phone (207) 973-8837

Organizations & group practices 5

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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1396300430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011036",
            "telephone_number": "336-235-0866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARYKATE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "7068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.