Individual provider Active NPI

Timothy E O'Leary, D.C.

  • Chiropractor
  • Peabody, MA
National Provider Identifier
1629098272
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3075 Issued in MA
Practice address
49 Central St
Peabody, MA 01960-4375
Phone
(978) 531-0202
Fax
(978) 532-7076
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3075 MA Primary

Addresses

Primary practice location

49 Central St
Peabody, MA 01960-4375

Mailing address

49 Central St
Peabody, MA 01960-4375
Phone (978) 531-0202

Other identifiers 1

IdentifierTypeStateIssuer
Y37137OtherMABCBSMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000354 MA Practitioner - Chiropractic 4789680471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

49 Central St
Peabody, MA 01960-4375
Phone (978) 531-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3075MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Peabody Family Chiropractic, Inc. CurrentSince Sep 19, 2007 Accepting new patients
Charles Street Family Chiropractic, Inc Chiropractor PastSince Jul 10, 2006 Accepting new patients

Locations

49 Central St
Peabody, MA 01960
Phone (978) 531-0202

Interoperability endpoints

  • Direct secure messaging: dr.tim@pfc0019.direct.chirotouch.md

Organizations & group practices 2

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381708800000",
    "number": "1629098272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CENTRAL ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604375",
            "telephone_number": "978-531-0202",
            "fax_number": "978-532-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 CENTRAL ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604375",
            "telephone_number": "978-531-0202",
            "fax_number": "978-532-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'LEARY",
        "first_name": "TIMOTHY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "Y37137",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.