Kellyann O'Brien, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA4823 Issued in MA

Practice address

3400 Main St
Springfield, MA 01107-1113

Phone

(413) 794-9560

Fax

(413) 794-5884

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

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 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

Yale University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628
  Medicare reassignment Care Compare group
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Saugus, MA
  • NPI 1255022638
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Ludlow, MA
  • NPI 1588355952
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Newburyport, MA
  • NPI 1316428824
  NPD (past)
• Hampden County Physician Associates, LLC.

  • Sleep Medicine (Internal Medicine) Physician
  • Southwick, MA
  • NPI 1548567696
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1619910155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991619",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071113",
            "telephone_number": "413-794-9560",
            "fax_number": "413-794-5884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "471 Center St",
            "address_purpose": "LOCATION",
            "city": "Ludlow",
            "state": "MA",
            "postal_code": "010562733",
            "country_code": "US",
            "telephone_number": "413-625-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KELLYANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin K O'Brien Donohue, CRNA
• Catherine O'Brien, CRNA
• Colleen M O'Brien
• Dennis J O'Brien, RN
• Dennis S O'Brien, PAC
• Kerry Joan O'Brien, BS
• Patrick K O'Brien
• Patrick W. O'Brien, PA-C
• O'Connell Professional Nurse Service Inc.
• Christopher William O'Connell

• Medical Physician Assistant in Springfield, MA
• Providers in Springfield, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.