Edward J O'Connor, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A24400 Issued in CA

Practice address

2811 Wilshire Blvd
Ste 790
Santa Monica, CA 90403-4805

Phone

(310) 829-5968

Fax

(310) 453-3685

NPI assigned

Jun 8, 2005

Reactivated

Mar 28, 2006

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

Enrolled in CA

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

Specialty

Neurology

Education

Other, 1970

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Edward J. O'Connor, MD, Inc.

  • Neurology Physician
  • Santa Monica, CA
  • NPI 1801079678
  Medicare reassignment NPD Authorized official
• Russ T Shimizu, M.D., Inc.

  • Neurology Physician
  • Santa Monica, CA
  • NPI 1912167461
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1568466555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "STE 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034805",
            "telephone_number": "310-829-5968",
            "fax_number": "310-453-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "STE 790",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034805",
            "telephone_number": "310-829-5968",
            "fax_number": "310-453-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "EDWARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2015-04-23",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A24400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maya Nyquist, AMFT, APCC
• J. Gray O'Brien, MSPT
• Lois M. O'Brien, M.D.
• Patrick O'Brien
• Lauren Joy O'Connell, LMFT
• Victoria O'Connor, M.D.
• Steven J O'Day, M.D.
• Linda K O'Dell, PH.D.
• Katy Aileen O'Donnell, MFTI
• Kevin Colin O'Fee, MD

• Neurology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.