Connor Matthew Dearborn

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

163 William St FL 5
New York, NY 10038-2613

Phone

(212) 618-6052

NPI assigned

Jul 14, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Post Road Medical Services PCGroup PAC ID 6406198506, 419 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

80.54 of 100Reported as group

Quality

70.76

Improvement activities

40

Cost

76.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• East Post Road Medical Services PC

  • Emergency Medicine Physician
  • White Plains, NY
  • NPI 1841767274
  Medicare reassignment Care Compare group
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD (past)
• Emergency Physicians of Englewood, PC

  • Emergency Medicine Physician
  • Englewood, NJ
  • NPI 1891046264
  Medicare reassignment
• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Montefiore Medical Center

  • Family Medicine Physician
  • New York, NY
  • NPI 1760288278
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• White Plains Hospital Medical Center

  dba White Plains Hospital Center

  • General Acute Care Hospital
  • White Plains, NY
  • NPI 1447255153
  Care Compare affiliation

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1780256230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 WILLIAM ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382613",
            "telephone_number": "212-618-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 WILLIAM ST FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382613",
            "telephone_number": "212-618-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARBORN",
        "first_name": "CONNOR",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Deangelis
• Teresa Maria Deangelis, M.D.
• Ann Marie Deangelo
• Gabriella Tucci Deangelo
• Bertha Dear, RN
• Kellie Boeggeman Dearden, ARNP
• Meagan Mary J Deardorff
• Helen Farrell Dearie
• Lee D Dearing, CRNA
• Anne Michelle Dearwater, PT, DPT

• Physician Assistant in New York, NY
• Providers in New York, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.