NPIMap

Individual provider Active NPI

Brian Michael O'Connell, DPT

  • Physical Therapist
  • Frackville, PA
National Provider Identifier
1750492377
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018207 Issued in PA
Practice address
401 S Lehigh Ave
Frackville, PA 17931-2436
Phone
(570) 874-3530
Fax
(570) 874-3283
NPI assigned
Aug 31, 2006
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT018207 PA Primary

Addresses

Primary practice location

401 S Lehigh Ave
Frackville, PA 17931-2436

Mailing address

430 Innovation Drive
Blairsville, PA 15717-8096
Phone (724) 343-4060

Other identifiers 5

IdentifierTypeStateIssuer
1750492377OtherPAORTHONET
1878706OtherPAHIGHMARK BLUE SHIELD
1019541330001MedicaidPA
232918467OtherPAAETNA
50095047OtherPACAPITAL BLUE CROSS

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

State licenses

LicenseStateTypeSpecialty
PT018207PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rehabilitation and Health Services, Inc. Past Accepting new patients
Good Shepherd Rehabilitation Hospital Past Accepting new patients
Pottsville Area Physical Therapy Services P.C. Physical Therapist Past Accepting new patients
Phoenix Rehabilitation and Health Services, Inc. Physical Therapist Past Accepting new patients
Phoenix Rehabilitation and Health Services, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11391/brand/2/csg/21/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1750492377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 INNOVATION DRIVE",
            "city": "BLAIRSVILLE",
            "state": "PA",
            "postal_code": "157178096",
            "telephone_number": "724-343-4060",
            "fax_number": "724-343-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S LEHIGH AVE",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179312436",
            "telephone_number": "570-874-3530",
            "fax_number": "570-874-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT018207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORTHONET",
            "identifier": "1750492377",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1878706",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019541330001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "232918467",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50095047",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frackville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.