Individual provider Active NPI

Jeremiah Wycoff Oconnor

  • Family Medicine Physician
  • Hanford, CA
National Provider Identifier
1629770854
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DOS-2966 Issued in HI
Practice address
1025 N Douty St
Hanford, CA 93230-3722
Phone
(559) 537-0170
NPI assigned
Mar 21, 2023
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DOS-2966 HI Primary

Addresses

Primary practice location

1025 N Douty St
Hanford, CA 93230-3722

Mailing address

1025 N Douty St
Hanford, CA 93230-3722

Other practice location 1

95-1249 Meheula Pkwy Bldg M
Mililani, HI 96789-1779
Phone (808) 625-6444

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240206003476 CA Order and Referring Only - Family PracticePractitioner - Family Practice 2860835923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DOS-2966HIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1629770854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 N DOUTY ST",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932303722",
            "telephone_number": "559-537-0170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95-1249 Meheula Pkwy Bldg M",
            "address_purpose": "LOCATION",
            "city": "Mililani",
            "state": "HI",
            "postal_code": "967891779",
            "country_code": "US",
            "telephone_number": "808-625-6444",
            "fax_number": "808-623-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "JEREMIAH",
        "middle_name": "WYCOFF",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "DOS-2966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanford, CA

Sources for this page

Verify at the official NPI Registry.