NPIMap

Individual provider Active NPI

John O'Shea, PA-C

  • Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1750856647
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031458 Issued in VT
Practice address
107 E Oak Ave
Flagstaff, AZ 86001-1818
Phone
(928) 779-7880
NPI assigned
Oct 8, 2018
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10516 AZ
Physician Assistant 363A00000X 055.0031458 VT Primary

Addresses

Primary practice location

107 E Oak Ave
Flagstaff, AZ 86001-1818

Mailing address

575 Turnpike St Ste 21
North Andover, MA 01845-5937
Phone (978) 794-1946

Other practice location 1

323 Lowell Street
West Wing, 1st Floor
Andover, MA 01810
Phone (978) 794-1946

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240829000719 AZ Practitioner - Physician Assistant 2062751167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winslow Memorial Hospital IncGroup PAC ID 8628988409, 44 clinicians

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

200 Lee St
Winslow, AZ 86047-2603
Phone (928) 289-3396

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10516AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Sep 1, 2024 Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Eone Medical PLLC Past Accepting new patients

Locations

340 S Willard St
Cottonwood, AZ 86326
Phone (928) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

200 Lee St
Winslow, AZ 86047
Phone (928) 226-6400

Organizations & group practices 4

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 7

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1750856647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 TURNPIKE ST STE 21",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455937",
            "telephone_number": "978-794-1946",
            "fax_number": "978-975-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E OAK AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011818",
            "telephone_number": "928-779-7880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 Lowell Street",
            "address_2": "West Wing, 1st Floor",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "MA",
            "postal_code": "01810",
            "country_code": "US",
            "telephone_number": "978-794-1946",
            "fax_number": "978-975-3925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10516",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.