Individual provider Active NPI

Eileen O'Hara

  • Gerontology Nurse Practitioner
  • New York, NY
National Provider Identifier
1831240712
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
340470 Issued in NY
Practice address
1 Penn PLZ
8TH Floor
New York, NY 10119-0002
Phone
(212) 216-6652
Fax
(855) 453-0909
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 340470 NY Primary

Addresses

Primary practice location

1 Penn PLZ
8TH Floor
New York, NY 10119-0002

Mailing address

1 Penn Plaza 8TH Floor
Optum
New York, NY 10119
Phone (212) 216-6652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Clinical LTC Associates of Georgia, PC Gerontology CurrentSince Mar 5, 2024 Accepting new patients

Locations

1040 Crown Pointe Pkwy
Ste 600
Atlanta, GA 30338
Phone (770) 698-9040

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1831240712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN PLAZA 8TH FLOOR",
            "address_2": "OPTUM",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10119",
            "telephone_number": "212-216-6652",
            "fax_number": "855-453-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "212-216-6652",
            "fax_number": "855-453-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HARA",
        "first_name": "EILEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "340470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.