Individual provider Active NPI

Colin Thomas O'Connor, PA-C

  • Physician Assistant
  • Apple Valley, MN
National Provider Identifier
1770979536
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12393 Issued in MN
Practice address
15350 English Ave
Apple Valley, MN 55124-6252
Phone
(952) 853-8800
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12393 MN Primary

Addresses

Primary practice location

15350 English Ave
Apple Valley, MN 55124-6252

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516
Phone (952) 853-8800

Other practice location 1

3930 Northwoods Dr
Arden Hills, MN 55112-6963
Phone (952) 853-8800

Other practice location 2

205 Wabasha St S
Saint Paul, MN 55107-1805
Phone (952) 853-8800

Other practice location 3

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (952) 853-8800

Other practice location 4

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (952) 853-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919003187 MN Practitioner - Physician Assistant 0749573590 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

205 Wabasha Ave S
Saint Paul, MN 55107-1805

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

3930 Northwood Dr
Arden Hills, MN 55112-6963

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12393MNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Group Health, Inc. CurrentSince Mar 4, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Group Health Plan, Inc. CurrentSince Mar 4, 2019 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

15350 English Ave
Apple Valley, MN 55124
Phone (952) 431-8500

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

15290 Pennock Ln
Saint Paul, MN 55124
Phone (952) 431-8500

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

Organizations & group practices 6

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 8

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1770979536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-853-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15350 ENGLISH AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551246252",
            "telephone_number": "952-853-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3930 Northwoods Dr",
            "address_purpose": "LOCATION",
            "city": "Arden Hills",
            "state": "MN",
            "postal_code": "551126963",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Wabasha St S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551071805",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8450 Seasons Pkwy",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551254402",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 Como Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551081460",
            "country_code": "US",
            "telephone_number": "952-853-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "COLIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.