Individual provider Active NPI

William Thomas O'Connor Jr., M.D.

  • Family Medicine Physician
  • Vacaville, CA
National Provider Identifier
1639127632
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G048496 Issued in CA
Practice address
300 Mason St.
Vacaville, CA 95688-4506
Phone
(707) 446-0422
Fax
(707) 446-1655
NPI assigned
May 4, 2006
Last updated
Dec 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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 G048496 CA Primary

Addresses

Primary practice location

300 Mason St.
Vacaville, CA 95688-4506

Mailing address

300 Mason St.
Vacaville, CA 95688-4506
Phone (707) 446-0422

Other identifiers 1

IdentifierTypeStateIssuer
00G484960MedicaidCA

Other names 1

  • Dr. William Thomas O'Connor Jr. Professional name

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
I20110721000073 CA Practitioner - Family PracticePractitioner - General Practice 0648448589 Practice locations: Vacaville, CA

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
University of Cincinnati College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 Mason St
Vacaville, CA 95688-4506
Phone (707) 446-0422

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue71
Removal of skin lesions98
Removal of nail tissue22
Removal or shaving of skin growth1-10
Skin biopsy26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Hospitals Past Accepting new patients

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1639127632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MASON ST.",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884506",
            "telephone_number": "707-446-0422",
            "fax_number": "707-446-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MASON ST.",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884506",
            "telephone_number": "707-446-0422",
            "fax_number": "707-446-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G048496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G484960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "O'CONNOR",
            "middle_name": "THOMAS",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

Verify at the official NPI Registry.