Active NPI
Kevin F Staveley-Ocarroll, M.D.
- Surgery Physician
- Farmington, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 076526
- Practice address
- 263 Farmington Avenue
Farmington, CT 06030-8063 - Phone
- (860) 679-8080
- Fax
- (860) 679-1340
- NPI assigned
- Apr 25, 2006
- Last updated
- Mar 5, 2024
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 076526 | CT | Primary |
| Surgery Physician | 208600000X | MD071461L | PA | |
| Surgery Physician | 208600000X | 2015030565 | MO | |
| Surgical Oncology Physician | 2086X0206X | 35558 | SC | |
| Surgical Oncology Physician | 2086X0206X | 2015030565 | MO |
Addresses
Primary practice location
263 Farmington Avenue
Farmington, CT 06030-8063
Mailing address
263 Farmington Avenue
Farmington, CT 06030-8063
Phone (860) 679-8080
Other practice location 1
1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 884-4854
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018125830001 | Medicaid | PA |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | MUDOCREFERRAL@direct.health.missouri.edu | Direct | Curators of the University of Missouri |
| Direct Messaging Address | kstaveleyocarroll74125@direct.med.uchc.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Oklahoma College of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 076526 | CT | MD | Surgery Physician |
| 2015030565 | MO | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Connecticut Health Center | Current | Accepting new patients | |
| University of Connecticut Health Center | Surgical Oncology | Current | Accepting new patients |
| University of Connecticut Health Center | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477
65 Kane St
West Hartfrd, CT 06119
Phone (860) 523-6421
Interoperability endpoints
- kstaveleyocarroll74125@direct.med.uchc.edu
Organizations & group practices 4
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 University Physicians
- General Practice Physician
- Farmington, CT
- NPI 1720083769
Surgical Oncology
-
dba University Physicians
- Durable Medical Equipment & Medical Supplies
- Farmington, CT
- NPI 1104809375
-
- Clinical Medical Laboratory
- Farmington, CT
- NPI 1427031293
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Middletown, CT
- NPI 1154263713
-
- General Acute Care Hospital
- Farmington, CT
- NPI 1669466561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709596800000",
"number": "1679539803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVENUE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060308063",
"telephone_number": "860-679-8080",
"fax_number": "860-679-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVENUE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060308063",
"telephone_number": "860-679-8080",
"fax_number": "860-679-1340"
}
],
"practiceLocations": [
{
"address_1": "1 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652120001",
"country_code": "US",
"telephone_number": "573-884-4854",
"fax_number": "573-884-6054",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STAVELEY-OCARROLL",
"first_name": "KEVIN",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-25",
"last_updated": "2024-03-05",
"certification_date": "2024-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "076526",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "PA",
"license": "MD071461L",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2015030565",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "SC",
"license": "35558",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "MO",
"license": "2015030565",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018125830001",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "MUDOCREFERRAL@direct.health.missouri.edu",
"affiliation": "Y",
"endpointDescription": "Endpoint is used to receive electronic continuity of care documents (C-CDA) for outpatient referrals.",
"affiliationName": "Curators of the University of Missouri",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct",
"address_1": "1 Hospital Dr",
"city": "Columbia",
"state": "MO",
"country_code": "US",
"postal_code": "652015276",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kstaveleyocarroll74125@direct.med.uchc.edu",
"affiliation": "N",
"address_1": "263 Farmington Avenue",
"city": "Farmington",
"state": "CT",
"country_code": "US",
"postal_code": "060308063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Farmington, CT
- State of Connecticut Health Center
- State of Connecticut Health Center (Correctional Managed Health Care)
- State of Connecticut Health Center
- State of Connecticut Health Center
- State of Connecticut Health Center
- David C Steffens, MD
- Michael P Steinberg, MD
- Stephanie Paul, L.C.S.W. LLC
- Caroline Easton Stern, DDS
- Jonathan Max Stern, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.