Active NPI
Thomas Edward O'Leary, D.O.
- Pediatrics Physician
- Dudley, MA
National Provider Identifier
1497742803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 217822
- Practice address
- 161 W Main St
Dudley, MA 01571-3817 - Phone
- (508) 949-7707
- Fax
- (508) 949-6737
- NPI assigned
- Sep 30, 2005
- Last updated
- Dec 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 217822 | MA | Primary |
Addresses
Primary practice location
161 W Main St
Dudley, MA 01571-3817
Mailing address
161 W Main St
Dudley, MA 01571-3817
Phone (508) 949-7707
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2020360 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 217822 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1497742803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 W MAIN ST",
"city": "DUDLEY",
"state": "MA",
"postal_code": "015713817",
"telephone_number": "508-949-7707",
"fax_number": "508-949-6737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 W MAIN ST",
"city": "DUDLEY",
"state": "MA",
"postal_code": "015713817",
"telephone_number": "508-949-7707",
"fax_number": "508-949-6737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'LEARY",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "217822",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2020360",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dudley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.