Active NPI
Michael O'Connor, DPT
- Physical Therapist
- Tampa, FL
National Provider Identifier
1669148284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT37586
- Practice address
- 13330 Usf Laurel Dr
Tampa, FL 33612-6601 - Phone
- (813) 821-8038
- Fax
- (813) 974-4325
- NPI assigned
- Aug 23, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT37586 | FL | Primary |
Addresses
Primary practice location
13330 Usf Laurel Dr
Tampa, FL 33612-6601
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 821-8038
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111650000 | Medicaid | FL | |
| Y911W | Other | FL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | moconnor199190@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2909 S 12TH St
Tacoma, WA 98405-2540
Phone (253) 336-2040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT37586 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiostrength LLC | Physical Therapist | Current | Accepting new patients |
| Tampa General Hospital | Current | Accepting new patients |
Locations
2909 S 12th St
Tacoma, WA 98405
Phone (253) 336-2040
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Tacoma, WA
- NPI 1073025490
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634515200000",
"number": "1669148284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001",
"telephone_number": "813-821-8038",
"fax_number": "813-974-4325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13330 USF LAUREL DR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336126601",
"telephone_number": "813-821-8038",
"fax_number": "813-974-4325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-23",
"last_updated": "2021-10-18",
"certification_date": "2021-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT37586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111650000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y911W",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "moconnor199190@direct.tgh.org",
"affiliation": "N",
"address_1": "13330 Usf Laurel Dr",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336126601",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.