Individual provider Active NPI

John Bernard O'Hara, PSY.D.

  • Clinical Neuropsychologist
  • Hartford, CT
National Provider Identifier
1700553823
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
200 Retreat Address
Hartford, CT 06106-3309
Phone
(860) 545-7940
Fax
(860) 545-7950
NPI assigned
Aug 26, 2021
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU Primary
Health Service Psychologist 103TH0100X NU
Group Psychotherapy Psychologist 103TP2701X NU

Addresses

Primary practice location

200 Retreat Address
Hartford, CT 06106-3309

Mailing address

1290 Silas Deane Highway
HHC - Cvo
Wethersfield, CT 06109-4337

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230919002416 CT Practitioner - Clinical Psychologist 5395136998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

200 Retreat Ave
Hartford, CT 06106-3310
Phone (860) 545-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1067NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Hartford Hospital Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients
Hartford Hospital Multi-Specialty CurrentSince Sep 1, 2023 Accepting new patients

Locations

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1700553823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HIGHWAY",
            "address_2": "HHC - CVO",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT ADDRESS",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7940",
            "fax_number": "860-545-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "JOHN",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.