Kelly O'Connor, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

295157 Issued in MA

Practice address

75 Washington St Ste 200
Norwell, MA 02061-1795

Phone

(781) 878-6495

Fax

(781) 878-7650

NPI assigned

Mar 23, 2018

Last updated

Oct 25, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Dermatology

Education

Tulane University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Dermatology Associates PCGroup PAC ID 3072403799, 84 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northeast Dermatology Associates, PC

  • Specialist
  • North Andover, MA
  • NPI 1104921162
  Medicare reassignment Care Compare group NPD
• South Shore Skin Center, LLC

  • Specialist
  • Plymouth, MA
  • NPI 1790763159
  Medicare reassignment NPD
• Neda at North Shore PC

  • Dermatology Physician
  • Marblehead, MA
  • NPI 1902345861
  NPD

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1659875540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 INNOVATION DR STE 400",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678000",
            "telephone_number": "217-433-2804",
            "fax_number": "888-977-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST STE 200",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611795",
            "telephone_number": "781-878-6495",
            "fax_number": "781-878-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KELLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "280743",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "295157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kelly.oconnor@bmc.org",
            "affiliation": "N",
            "address_1": "609 Albany St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021182515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara J Nuciforo, MD
• Nutrapy, LLC (New England Wellness Solutions)
• Robert Louis Nutt, MSW
• Kimberly O'Brien, LMHC
• Caroline Ann O'Connor-David
• Maura O'Connor
• Genevieve Mary O'Donnell
• Kelly Marie O'Gara, LMHC
• Destiny O'Garro
• Jacquelyn O'Keefe

• Dermatology Physician in Norwell, MA
• Providers in Norwell, MA by specialty
• Dermatology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.