Jordan O'Connor, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4141 Issued in MA

Practice address

55 Fogg Rd
Weymouth, MA 02190

Phone

(781) 624-3889

Fax

(781) 624-6730

NPI assigned

Feb 24, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jordan Manly Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as group

Quality

88.12

Promoting interoperability

71

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment Care Compare group
• South Shore Medical Center, Inc.

  • Internal Medicine Physician
  • Norwell, MA
  • NPI 1669411856
  Medicare reassignment

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1598062713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 85",
            "address_2": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-3889",
            "fax_number": "781-624-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-624-3889",
            "fax_number": "781-624-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JORDAN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-24",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "MANLY",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela O'Brien, MS OTR/L
• Barbara Marie O'Brien, MD
• Caroline O'Brien
• Daniel R O'Brien, CRNA
• Olga O'Brien, ABA
• Kaitlin Ann O'Connor, D.O.
• Kendra O'Connor
• Shannon O'Connor, MSW, LCSW
• Thomas Patrick O'Connor Jr., M.D.
• Michael Christopher O'Gorman, M.D.

• Physician Assistant in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.