Individual provider Active NPI

John Patrick O'Connor, MD

  • Family Medicine Physician
  • Marathon, FL
National Provider Identifier
1659465458
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0066592 Issued in FL
Practice address
13365 Overseas Hwy
Suite 102
Marathon, FL 33050
Phone
(305) 743-9436
Fax
(305) 743-9612
NPI assigned
Oct 3, 2006
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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 ME0066592 FL Primary

Addresses

Primary practice location

13365 Overseas Hwy
Suite 102
Marathon, FL 33050

Mailing address

13365 Overseas Hwy
Suite 102
Marathon, FL 33050
Phone (305) 743-9436

Other identifiers 2

IdentifierTypeStateIssuer
25759OtherFLBLUE CROSS OF FL
377984000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110719000286 FL Practitioner - Family Practice 3274566880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bruce L Boros MD PAGroup PAC ID 1658359062, 16 clinicians

Practice addresses (Care Compare)

13365 Overseas Hwy
Suite 102
Marathon, FL 33050-3513
Phone (305) 294-0011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce L Boros MD PA CurrentSince Mar 1, 2020 Accepting new patients
Bruce L Boros MD PA Current Accepting new patients
Bruce L Boros MD PA CurrentSince Mar 1, 2020 Accepting new patients
Fishermen's Hospital, Inc. Past Accepting new patients

Locations

100460 Overseas Hwy
Ste 4
Key Largo, FL 33037
Phone (305) 453-3337

1980 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 294-0011

2407 N Roosevelt Blvd
Key West, FL 33040
Phone (305) 293-9555

13365 Overseas Hwy
Ste 102
Marathon, FL 33050
Phone (305) 294-0011

Organizations & group practices 5

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1659465458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13365 OVERSEAS HWY",
            "address_2": "SUITE 102",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "33050",
            "telephone_number": "305-743-9436",
            "fax_number": "305-743-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13365 OVERSEAS HWY",
            "address_2": "SUITE 102",
            "city": "MARATHON",
            "state": "FL",
            "postal_code": "33050",
            "telephone_number": "305-743-9436",
            "fax_number": "305-743-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0066592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF FL",
            "identifier": "25759",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377984000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marathon, FL

Sources for this page

Verify at the official NPI Registry.