Individual provider Active NPI

Kevin O'Hagan

  • Chiropractor
  • Rochester, NY
National Provider Identifier
1497308688
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
013257 Issued in NY
Practice address
1717 East Ave
Rochester, NY 14610-1822
Phone
(631) 942-6208
NPI assigned
Jul 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 013257 NY Primary

Addresses

Primary practice location

1717 East Ave
Rochester, NY 14610-1822

Mailing address

24 Sisson Dr
Rochester, NY 14623-4320
Phone (631) 942-6208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191218000596 NY Practitioner - Chiropractic 2961836382 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
013257NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Associates of Rochester Chiropractor CurrentSince Nov 13, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1497308688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SISSON DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234320",
            "telephone_number": "631-942-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 EAST AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146101822",
            "telephone_number": "631-942-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HAGAN",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "013257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.