Rory Stephen O'Connor, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-770 Issued in ID

Practice address

500 W Fort St
# 111
Boise, ID 83702

Phone

(208) 422-1325

Fax

(208) 422-1319

NPI assigned

Sep 25, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1487804589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "# 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-422-1325",
            "fax_number": "208-422-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "address_2": "# 111",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-422-1325",
            "fax_number": "208-422-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "RORY",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda L O'Brien, MS, RD
• Sarah O'Brien, LCSW
• Dawn Anna O'Connell
• Brittany O'Connor, MS, CCC-SLP
• Jared Galbraith O'Connor, PA-C
• Sara M O'Connor, NP
• Janat E. O'Donnell, MD
• Kevin O'Donnell, FNP
• Kelly O'Leary
• Kelsey O'Leary

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.