Individual provider Active NPI

Lucy Kathleen O'Brien, D.O.

  • Family Medicine Physician
  • Broadview Heights, OH
National Provider Identifier
1487911814
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.011502 Issued in OH
Practice address
303 E Royalton Rd
Broadview Heights, OH 44147-2591
Phone
(440) 743-8130
Fax
(440) 743-8131
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 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 34.011502 OH Primary

Addresses

Primary practice location

303 E Royalton Rd
Broadview Heights, OH 44147-2591

Mailing address

2244 Winfield Ave
Rocky River, OH 44116-2877
Phone (810) 624-1675

Other practice location 1

1350 W Bagley Rd
Berea, OH 44017-2912
Phone (440) 816-5188

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lobrien@direct.swgeneral.com Southwest General Medical Group Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150123001313 OH Practitioner - Family Practice 5496079345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1350 W Bagley Rd
Berea, OH 44017-2912
Phone (440) 816-5188

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34.011502OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc CurrentSince Apr 20, 2020 Accepting new patients
North Coast Professional Company, LLC Family Medicine CurrentSince Jan 1, 2015 Accepting new patients
North Coast Professional Company, LLC CurrentSince Jan 1, 2015 Accepting new patients
Southwest General Medical Group Inc Family Medicine CurrentSince Apr 20, 2020 Accepting new patients

Locations

1350 W Bagley Rd
Berea, OH 44017
Phone (440) 816-5188

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

1605 State Route 60
Ste 9
Vermilion, OH 44089
Phone (440) 967-1128

Interoperability endpoints

  • Direct secure messaging: lobrien@direct.swgeneral.com

Organizations & group practices 4

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 2

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1487911814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 WINFIELD AVE",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441162877",
            "telephone_number": "810-624-1675",
            "fax_number": "440-743-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ROYALTON RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472591",
            "telephone_number": "440-743-8130",
            "fax_number": "440-743-8131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 W Bagley Rd",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440172912",
            "country_code": "US",
            "telephone_number": "440-816-5188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "LUCY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.011502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lobrien@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "1350 W Bagley Rd",
            "city": "Berea",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440172912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Broadview Heights, OH

Sources for this page

Verify at the official NPI Registry.