Individual provider Active NPI

Lauren Jane O'Brien, PA

  • Surgical Physician Assistant
  • Worcester, MA
National Provider Identifier
1447897020
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA8503 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(774) 443-7552
Fax
(774) 441-6086
NPI assigned
Dec 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01201 RI
Surgical Physician Assistant 363AS0400X PA8503 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

119 Belmont St
Worcester, MA 01605-2903
Phone (774) 443-7552

Other practice location 2

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Other practice location 3

300A Faunce Corner Rd
North Dartmouth, MA 02747-1280
Phone (508) 973-2213

Other identifiers 1

IdentifierTypeStateIssuer
110179690AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20220216002907 MA Practitioner - Physician Assistant 5597158428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Yale University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

101 Page St
New Bedford, MA 02740-3464
Phone (508) 973-5919

300 B Faunce Corner Rd
North Dartmouth, MA 02747-1257
Phone (508) 973-2230

363 Highland Ave
Fall River, MA 02720-3703
Phone (508) 973-5919

534 Prospect St
Fall River, MA 02720-5281
Phone (508) 973-7766

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01201RIMDPhysician Assistant
PA8503MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Nov 7, 2023 Accepting new patients
Southcoast Physicians Group, Inc. Past Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

300A Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-2213

Interoperability endpoints

  • Direct secure messaging: lobrien64618@direct.southcoast.org

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 1

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": "1575331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1447897020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "774-443-7552",
            "fax_number": "774-441-6086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "774-443-7552",
            "fax_number": "774-441-6086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300A Faunce Corner Rd",
            "address_purpose": "LOCATION",
            "city": "North Dartmouth",
            "state": "MA",
            "postal_code": "027471280",
            "country_code": "US",
            "telephone_number": "508-973-2213",
            "fax_number": "508-973-1185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "LAUREN",
        "middle_name": "JANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-03",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01201",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA8503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110179690A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.