Individual provider Active NPI

Tina Marie Oneill, NP

  • Adult Health Nurse Practitioner
  • Carthage, NY
National Provider Identifier
1780723007
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F3005691 Issued in NY
Practice address
117 N Mechanic St
Carthage, NY 13619-1252
Phone
(315) 493-3100
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3005691 NY Primary

Addresses

Primary practice location

117 N Mechanic St
Carthage, NY 13619-1252

Mailing address

117 N Mechanic St
Carthage, NY 13619-1252
Phone (315) 493-1052

Other identifiers 1

IdentifierTypeStateIssuer
00583697MedicaidNY

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3005691NYMDAdult Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tina.oneill.p2@direct.usppny.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1780723007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N MECHANIC ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191252",
            "telephone_number": "315-493-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N MECHANIC ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136191252",
            "telephone_number": "315-493-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEILL",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3005691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00583697",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.