Active NPI
Janet O'Brien, R PA
- Medical Physician Assistant
- Goshen, NY
National Provider Identifier
1619984051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 011101-1
- Practice address
- 30 Hatfield Lane Suite 105
Diamond Institue
Goshen, NY 10924 - Phone
- (845) 291-1111
- Fax
- (845) 291-1103
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sonography Radiologic Technologist | 2471S1302X | 0746 | ||
| Physician Assistant | 363A00000X | 011101-1 | NY | |
| Physician Assistant | 363A00000X | 25MP00157600 | NJ | |
| Medical Physician Assistant | 363AM0700X | 011101-1 | NY | Primary |
| Medical Physician Assistant | 363AM0700X | 25MP00157600 | NJ |
Addresses
Primary practice location
30 Hatfield Lane Suite 105
Diamond Institue
Goshen, NY 10924
Mailing address
30 Hatfield Lane Suite 105
Diamond Institue
Goshen, NY 10924
Phone (845) 291-1111
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)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011101-1 | NY | MD | Physician Assistant |
| 25MP00157600 | NJ | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296777600000",
"number": "1619984051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 HATFIELD LANE SUITE 105",
"address_2": "DIAMOND INSTITUE",
"city": "GOSHEN",
"state": "NY",
"postal_code": "10924",
"telephone_number": "845-291-1111",
"fax_number": "845-291-1103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 HATFIELD LANE SUITE 105",
"address_2": "DIAMOND INSTITUE",
"city": "GOSHEN",
"state": "NY",
"postal_code": "10924",
"telephone_number": "845-291-1111",
"fax_number": "845-291-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'BRIEN",
"first_name": "JANET",
"name_prefix": "Mrs.",
"credential": "R PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2011-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2471S1302X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Sonography",
"state": null,
"license": "0746",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "011101-1",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00157600",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "011101-1",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NJ",
"license": "25MP00157600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goshen, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.