Individual provider Active NPI

Kevin O'Connor, NP

  • Family Nurse Practitioner
  • Seaford, NY
National Provider Identifier
1396454435
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F352584-01 Issued in NY
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

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Home health agency, Hauppauge, NY, CCN 337232
  • VNS & Hospice of Suffolk Inc Chha Home health agency, Northport, NY, CCN 337014
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
530505NYMDRegistered Nurse
F352584-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
House Call Health Long Island PLLC CurrentSince Aug 3, 2025 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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.