Active NPI
Kevin O'Connor, NP
- Family Nurse Practitioner
- Seaford, NY
National Provider Identifier
1396454435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F352584-01
- Practice address
- 3887 Beacon Rd
Seaford, NY 11783-3602 - Phone
- (631) 520-8771
- NPI assigned
- Nov 17, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F352584-01 | NY | Primary |
| Registered Nurse | 163W00000X | 530505 | NY |
Addresses
Primary practice location
3887 Beacon Rd
Seaford, NY 11783-3602
Mailing address
267 E Main St BLDG C
Smithtown, NY 11787-2847
Phone (631) 418-8069
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240406000149 | NY | Practitioner - Nurse Practitioner | 2961840194 | Practice locations: Seaford, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- State University of New York at Stony Brook, School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 1554
Stony Brook, NY 11790
PO Box
Suite 1554
Stony Brook, NY 11790-0988
Hospital & facility affiliations
- Centerwell Home Health
- VNS & Hospice of Suffolk Inc Chha
- Catholic Home Care
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 530505 | NY | MD | Registered Nurse |
| F352584-01 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| House Call Health Long Island PLLC | Current | Accepting new patients | |
| Stony Brook Internists, University Faculty Practice Corporation | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
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.
-
- Nurse Practitioner
- Seaford, NY
- NPI 1336023654
-
- Medical Oncology Physician
- Stony Brook, NY
- NPI 1184679342
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Hauppauge, NY
- NPI 1376575977
-
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
-
- Home Health Agency
- Northport, NY
- NPI 1356494637
-
- Home Health Agency
- Northport, NY
- NPI 1770580516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775779200000",
"number": "1396454435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 E MAIN ST BLDG C",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872847",
"telephone_number": "631-418-8069",
"fax_number": "631-656-0470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3887 BEACON RD",
"city": "SEAFORD",
"state": "NY",
"postal_code": "117833602",
"telephone_number": "631-520-8771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "KEVIN",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-17",
"last_updated": "2026-04-10",
"certification_date": "2026-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "F352584-01",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "530505",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seaford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.