Kendra Marie O'Connor, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0008691 Issued in CO

Practice address

3260 S Corona St
Englewood, CO 80113-2816

Phone

(303) 257-0013

NPI assigned

Aug 15, 2024

Last updated

Aug 19, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CO

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Dermatology of Colorado PCGroup PAC ID 8325337330, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Dermatology of Colorado, PC

  • Dermatology Physician
  • Fort Collins, CO
  • NPI 1710370648
  Medicare reassignment Care Compare group
• Denver Skin Clinic, P.C

  • Dermatology Physician
  • Denver, CO
  • NPI 1992824197
  NPD (past)
• Dermatology & Laser Center at Harvard Park, PLLC

  dba Dermatology & Laser Center

  • Dermatology Physician
  • Denver, CO
  • NPI 1376645143
  NPD (past)

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1629800909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 S CORONA ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132816",
            "telephone_number": "303-257-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 S CORONA ST",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801132816",
            "telephone_number": "303-257-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KENDRA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0008691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rose-Delille Nozea, RN.BSN.MHM
• Rosa Erika Nunez, CNA
• Valerie Marie Nunez
• Hailey Nuss
• Martin M. O'Bryan
• Tara Gene O'Connor, FNP
• Marguerite Rose O'Farrell, M.D.
• Bernard Michael O'Grady, CHIROPRACTOR
• Kelly O'Hara
• Deirdre E O'Loughlin, FNP-C

• Physician Assistant in Englewood, CO
• Providers in Englewood, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.