Active NPI
James R O'Connell, MD
- Urology Physician
- Philadelphia, PA
National Provider Identifier
1639243900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD008797E
- Practice address
- 3400 Civic Center Blvd.
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127 - Phone
- (215) 662-2891
- Fax
- (215) 662-6734
- NPI assigned
- Nov 20, 2006
- Last updated
- Oct 3, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD008797E | PA | Primary |
| Urology Physician | 208800000X | 252428-1 | NY |
Addresses
Primary practice location
3400 Civic Center Blvd.
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127
Mailing address
3400 Civic Center Blvd.
West Pavilion, 3Rd Floor
Philadelphia, PA 19104-5127
Phone (215) 662-2891
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000641614 | Medicaid | PA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252428-1 | NY | MD | Urology Physician |
| MD008797E | PA | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | 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.
-
dba Icahn School of Medicine Pharmacy
- Specialty Pharmacy
- New York, NY
- NPI 1629410816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1639243900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD.",
"address_2": "WEST PAVILION, 3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-662-2891",
"fax_number": "215-662-6734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD.",
"address_2": "WEST PAVILION, 3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-662-2891",
"fax_number": "215-662-6734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNELL",
"first_name": "JAMES",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "PA",
"license": "MD008797E",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "252428-1",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000641614",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.