Individual provider Active NPI

Julie Rombaut O'Connor, M.D.

  • Family Medicine Physician
  • Lowell, MA
National Provider Identifier
1528389863
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257149 Issued in MA
Practice address
1081 Varnum Ave
Lowell, MA 01854
Phone
(978) 427-6810
Fax
(978) 427-6887
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LP01908 RI
Family Medicine Physician 207Q00000X 257149 MA Primary

Addresses

Primary practice location

1081 Varnum Ave
Lowell, MA 01854

Mailing address

1081 Varnum Ave
Lowell, MA 01854
Phone (978) 427-6810

Other names 1

  • Dr. Julie Rombaut Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20140117001005 MA Practitioner - Family Practice 6507094604 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01908RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Family Medicine CurrentSince Nov 4, 2013 Accepting new patients

Locations

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

3 Woodland Rd
Ste 119
Stoneham, MA 02180
Phone (781) 279-2454

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1528389863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01854",
            "telephone_number": "978-427-6810",
            "fax_number": "978-427-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "01854",
            "telephone_number": "978-427-6810",
            "fax_number": "978-427-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JULIE",
        "middle_name": "ROMBAUT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP01908",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "257149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "ROMBAUT",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.