Individual provider Active NPI

Brian Patrick Oconnor, MD

  • Rheumatology Physician
  • Pasadena, CA
National Provider Identifier
1770641870
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
G040893 Issued in CA
Practice address
675 S Arroyo Pkwy
Ste 400
Pasadena, CA 91105-3264
Phone
(626) 795-4116
Fax
(626) 568-3127
NPI assigned
Dec 4, 2006
Last updated
Jul 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X G040893 CA Primary

Addresses

Primary practice location

675 S Arroyo Pkwy
Ste 400
Pasadena, CA 91105-3264

Mailing address

675 S Arroyo Pkwy
Ste 400
Pasadena, CA 91105-3264
Phone (626) 795-4116

Other identifiers 1

IdentifierTypeStateIssuer
00G408930MedicaidCA

Other names 1

  • Brian P Oconnor Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090424000176 CA Practitioner - Rheumatology 1355499799 Practice locations: Pasadena, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G040893CAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Arcadia Hospital Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients

Organizations & group practices 2

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1770641870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY",
            "address_2": "STE 400",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053264",
            "telephone_number": "626-795-4116",
            "fax_number": "626-568-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY",
            "address_2": "STE 400",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053264",
            "telephone_number": "626-795-4116",
            "fax_number": "626-568-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G040893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G408930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "OCONNOR",
            "middle_name": "P",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.