Individual provider Active NPI

Dorene Anne O'Hara, MD

  • Ambulatory Surgical Clinic/Center
  • Reston, VA
National Provider Identifier
1679656607
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0101240686 Issued in VA
Practice address
1734 Seagull CT
Apt. 402
Reston, VA 20194-4307
Phone
(732) 423-8533
Fax
(571) 313-0523
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 048518 NJ
Ambulatory Surgical Clinic/Center 261QA1903X 0101240686 VA Primary

Addresses

Primary practice location

1734 Seagull CT
Apt. 402
Reston, VA 20194-4307

Mailing address

1734 Seagull CT
Apt. 402
Reston, VA 20194-4307
Phone (732) 423-8533

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
048518NJMDAnesthesiology Physician
0101240686VAMDAmbulatory Surgical Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Advantage PC Anesthesiology Past Accepting new patients
Anesthesia Advantage of Delaware, P.a. Anesthesiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1679656607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1734 SEAGULL CT",
            "address_2": "APT. 402",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201944307",
            "telephone_number": "732-423-8533",
            "fax_number": "571-313-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1734 SEAGULL CT",
            "address_2": "APT. 402",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201944307",
            "telephone_number": "732-423-8533",
            "fax_number": "571-313-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "DORENE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "048518",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "0101240686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.