Individual provider Active NPI

Nina R. O'Connor, MD

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1841212909
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD430666 Issued in PA
Practice address
1316 W Ontario St
Philadelphia, PA 19140-5220
Phone
(215) 707-2400
Fax
(215) 707-4034
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X MD430666 PA
Family Medicine Physician 207Q00000X MD430666 PA Primary

Addresses

Primary practice location

1316 W Ontario St
Philadelphia, PA 19140-5220

Mailing address

3500 N Broad St RM 1a
Philadelphia, PA 19140-4106
Phone (215) 926-9019

Other practice location 1

3400 Civic Center Blvd
Pcam 14
Philadelphia, PA 19104-5127
Phone (215) 614-1618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070823000659 PA Practitioner - Hospice/Palliative CarePractitioner - Family Practice 0143223388 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
University of Virginia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3322 N Broad St
Philadelphia, PA 19140-5185
Phone (210) 707-1800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD430666PAMDHospice and Palliative Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Temple Physicians Inc Family Medicine Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Aug 15, 2023 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Aug 15, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC CurrentSince Jan 1, 2010 Accepting new patients
Temple Physician Inc. CurrentSince Dec 22, 2023 Accepting new patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Oct 6, 2014 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 1, 2013 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 1, 2013 Accepting new patients
Temple Physicians Inc. Family Medicine CurrentSince Dec 22, 2023 Accepting new patients
Chestnut Hill Clinic Company, LLC Family Medicine CurrentSince Jan 1, 2010 Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients
Temple Faculty Practice Plan Inc Past Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

8815 Germantown Ave
Fl 5
Philadelphia, PA 19118
Phone (215) 248-8145

3322 N Broad St
Philadelphia, PA 19140
Phone (215) 707-4000

3400 Civic Center Blvd
#4
Philadelphia, PA 19104
Phone (215) 614-1618

3500 N Broad St
Rm 1A
Philadelphia, PA 19140
Phone (215) 707-2433

7600 Central Ave
Fl 2
Philadelphia, PA 19111
Phone (215) 725-7600

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

3400 Civic Center Blvd
#2W
Philadelphia, PA 19104
Phone (215) 614-1618

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

1316 W Ontario St
Philadelphia, PA 19140
Phone (215) 707-2400

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1841212909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N BROAD ST RM 1A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191404106",
            "telephone_number": "215-926-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 W ONTARIO ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405220",
            "telephone_number": "215-707-2400",
            "fax_number": "215-707-4034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Civic Center Blvd",
            "address_2": "PCAM 14",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191045127",
            "country_code": "US",
            "telephone_number": "215-614-1618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "NINA",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "PA",
            "license": "MD430666",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD430666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.