NPIMap

Individual provider Active NPI

Brandon Oconnor, M.D.

  • Family Medicine Physician
  • Port Jervis, NY
National Provider Identifier
1467624494
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA08721400 Issued in NJ
Practice address
9 Orchard St
Port Jervis, NY 12771
Phone
(845) 672-3017
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA08721400 NJ Primary

Addresses

Primary practice location

9 Orchard St
Port Jervis, NY 12771

Mailing address

132 Congress Rd
Milford, PA 18337-7057
Phone (845) 360-5530

Other practice location 1

1 Hatfield Ln Ste 2B
Goshen, NY 10924
Phone (845) 360-5530

Other practice location 2

137 Main Rd
Ste. 200
Montville, NJ 07045-9231
Phone (973) 402-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130227000147 NY Practitioner - Family Practice 2567643943 Reassigns benefits to 6 organizations
I20210901003715 PA Practitioner - Family Practice 2567643943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Milford, PA 18337
Phone (609) 661-2946

9 Orchard St
Port Jervis, NY 12771-2027
Phone (609) 661-2946

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08721400NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
O'Connor Medical PLLC Family Medicine CurrentSince Jun 13, 2022 Accepting new patients
Little Pediatrics P.C. CurrentSince Jun 16, 2018 Accepting new patients
Excel Urgent Care of Fishkill PLLC CurrentSince Oct 1, 2014 Accepting new patients
Excel Urgent Care of Goshen PLLC CurrentSince Nov 15, 2012 Accepting new patients
Southern Westchester Urgent Care PLLC CurrentSince May 30, 2016 Accepting new patients
Orange Urgent Care PLLC CurrentSince Jul 1, 2018 Accepting new patients
The Radiology Group of New Jersey, LLC PastSince Jun 19, 2015 Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients
Fishkill Pharmacy LLC PastSince Oct 1, 2014 Accepting new patients
Delaware Valley Skilled Nursing Operating Company, LLC Past Accepting new patients

Locations

1 Hatfield Ln
Ste 2B
Goshen, NY 10924
Phone (845) 360-5530

75 Crystal Run Rd
Ste G40
Middletown, NY 10941
Phone (845) 703-2273

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

1915 Central Park Ave
#25
Yonkers, NY 10710
Phone (914) 682-8485

Interoperability endpoints

  • Direct secure messaging: hackensackmeridian.brandonoconnor@136290.advancedmd-direct.com

Organizations & group practices 10

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.

Hospital & facility affiliations 11

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1467624494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 CONGRESS RD",
            "city": "MILFORD",
            "state": "PA",
            "postal_code": "183377057",
            "telephone_number": "845-360-5530",
            "fax_number": "845-360-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ORCHARD ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "12771",
            "telephone_number": "845-672-3017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hatfield Ln Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "NY",
            "postal_code": "10924",
            "country_code": "US",
            "telephone_number": "845-360-5530",
            "fax_number": "845-360-5526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 Main Rd",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Montville",
            "state": "NJ",
            "postal_code": "070459231",
            "country_code": "US",
            "telephone_number": "973-402-0025",
            "fax_number": "973-402-0508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "BRANDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08721400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

Verify at the official NPI Registry.