Individual provider Active NPI

Kevin Paul O'Connor, MD

  • Urology Physician
  • Leesburg, VA
National Provider Identifier
1730173279
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101048160 Issued in VA
Practice address
19415 Deerfield Ave Ste 112
Leesburg, VA 20176-8470
Phone
(703) 724-1195
Fax
(703) 724-4495
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101048160 VA Primary

Addresses

Primary practice location

19415 Deerfield Ave Ste 112
Leesburg, VA 20176-8470

Mailing address

224-D Cornwall Street, NW, Suite 403
Leesburg, VA 20176-2704
Phone (703) 737-6010

Other identifiers 3

IdentifierTypeStateIssuer
340017904OtherVARR MEDICARE
340017905OtherDCRR MEDICARE
1730173279MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090805000731 VA Practitioner - Urology 8426037441 Reassigns benefits to 2 organizations
I20090903000140 DC Practitioner - Urology 8426037441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Loudoun Medical Group, PCGroup PAC ID 0042119661, 272 clinicians
Gastrointestinal Specialists LLCGroup PAC ID 5294797957, 79 clinicians

Practice addresses (Care Compare)

1860 Town Ctr Dr
Suite 150
Reston, VA 20190-5905
Phone (703) 480-0220

19415 Deerfield Ave
Suite 112
Leesburg, VA 20176-8470
Phone (703) 724-1195

20955 Professional PLZ
Suite 200
Ashburn, VA 20147-3405
Phone (703) 729-7652

224 D Cornwall St NW
Leesburg, VA 20176-2700

224 D Cornwall St NW
Suite 400
Leesburg, VA 20176-2704
Phone (703) 443-6733

24430 Stone Springs Blvd
Suite 525
Dulles, VA 20166-2267
Phone (703) 957-1022

6602 W Broad St
Suite B
Richmond, VA 23230-1702
Phone (804) 285-8206

Hospital & facility affiliations

  • Inova Loudoun Hospital Hospital, Leesburg, VA, CCN 490043
  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005

Merit-based Incentive Payment System (MIPS)

Final score
92.65 of 100Reported as apm
Quality
85.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101048160VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loudoun Medical Group, PC CurrentSince Jun 1, 2000 Accepting new patients
Loudoun Medical Group, PC Urology CurrentSince Jun 1, 2000 Accepting new patients
Gastrointestinal Specialists LLC Urology CurrentSince Feb 1, 2026 Accepting new patients
Loudoun Medical Group, PC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

3301 New Mexico Ave NW
Ste 250
Washington, DC 20016
Phone (202) 517-7388

5249 Duke St
Ste 100
Alexandria, VA 22304
Phone (703) 370-2814

6355 Walker Ln
Ste 308
Alexandria, VA 22310
Phone (703) 313-7700

20955 Professional Plz
Ste 200
Ashburn, VA 20147
Phone (703) 729-7652

24430 Stone Springs Blvd
Ste 545
Dulles, VA 20166
Phone (703) 957-1022

44055 Riverside Pkwy
#20811302
Leesburg, VA 20176
Phone (703) 729-7652

44055 Riverside Pkwy
Ste 208
Leesburg, VA 20176
Phone (703) 729-7652

224D Cornwall St NW
Ste 403
Leesburg, VA 20176
Phone (703) 737-6001

224D Cornwall St NW
Ste 400
Leesburg, VA 20176
Phone (703) 443-6733

19415 Deerfield Ave
Ste 112
Leesburg, VA 20176
Phone (703) 724-1195

1860 Town Center Dr
Ste 150
Reston, VA 20190
Phone (703) 480-0220

6602 W Broad St
#B
Richmond, VA 23230
Phone (804) 289-1137

Interoperability endpoints

  • Direct secure messaging: kevin.oconnor@lmg1.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1730173279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224-D CORNWALL STREET, NW, SUITE 403",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762704",
            "telephone_number": "703-737-6010",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19415 DEERFIELD AVE STE 112",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201768470",
            "telephone_number": "703-724-1195",
            "fax_number": "703-724-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101048160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "340017904",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "340017905",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730173279",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

Verify at the official NPI Registry.