Individual provider Active NPI

Gale Oconnor, M.D.

  • Internal Medicine Physician
  • Orchard Park, NY
National Provider Identifier
1750398160
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1767201 Issued in NY
Practice address
3075 Southwestern Blvd
Suite 100
Orchard Park, NY 14127-1236
Phone
(716) 712-0490
Fax
(716) 712-0615
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1767201 NY Primary

Addresses

Primary practice location

3075 Southwestern Blvd
Suite 100
Orchard Park, NY 14127-1236

Mailing address

3075 Southwestern Blvd
Suite 100
Orchard Park, NY 14127-1236
Phone (716) 712-0490

Other identifiers 1

IdentifierTypeStateIssuer
01505182MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1767201NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750398160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD",
            "address_2": "SUITE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-712-0490",
            "fax_number": "716-712-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 SOUTHWESTERN BLVD",
            "address_2": "SUITE 100",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141271236",
            "telephone_number": "716-712-0490",
            "fax_number": "716-712-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "GALE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1767201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01505182",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orchard Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.