Organization Active NPI

Michael J Oneill MD PLLC

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1700250073
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MICHAEL J ONEILL MD PLLC
Practice address
1465 Kelly Johnson Blvd
Suite 310
Colorado Springs, CO 80920-3955
Phone
(719) 419-7490
Fax
(719) 309-6847
NPI assigned
Nov 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Authorized official

Name
Michael J O'Neill, MDNPI 1215943808
Title
President
Phone
(719) 465-1849

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1465 Kelly Johnson Blvd
Suite 310
Colorado Springs, CO 80920-3955

Mailing address

1465 Kelly Johnson Blvd
Suite 310
Colorado Springs, CO 80920-3955
Phone (719) 419-7490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160302002082 CO Part B Supplier - Clinic/Group Practice 8123324043 Receives reassigned benefits from 1 practitioner
Practice locations: Monument, CO

National Provider Directory

National Provider Directory

Locations

240 Beacon Lite Rd
Monument, CO 80132
Phone (719) 419-7490

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1700250073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD",
            "address_2": "SUITE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203955",
            "telephone_number": "719-419-7490",
            "fax_number": "719-309-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 KELLY JOHNSON BLVD",
            "address_2": "SUITE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203955",
            "telephone_number": "719-419-7490",
            "fax_number": "719-309-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J ONEILL MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-465-1849",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.