Individual provider Active NPI

Michelle O'Connor, NP

  • Pediatric Nurse Practitioner
  • Huntington, NY
National Provider Identifier
1861556763
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
381711 Issued in NY
Practice address
270 Park Ave
Huntington, NY 11743-2787
Phone
(631) 351-2426
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X F381711 NY
Pediatric Nurse Practitioner 363LP0200X 381711 NY Primary

Addresses

Primary practice location

270 Park Ave
Huntington, NY 11743-2787

Mailing address

270 Park Ave
Huntington, NY 11743-2787
Phone (631) 351-2426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050425000223 NY Practitioner - Nurse Practitioner 1052359569 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F381711NYMDPediatric Surgery Physician

Practice roles (5 of 9)

OrganizationSpecialtyStatusNew patients
Huntington Hospital Association CurrentSince Mar 28, 2010 Accepting new patients
North Shore-Lij Medical PC CurrentSince Nov 23, 2019 Accepting new patients
North Shore - Lij Medical PC CurrentSince Nov 23, 2019 Accepting new patients
Huntington Hospital Association CurrentSince Mar 28, 2010 Accepting new patients
Huntington Hospital Association Current Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

611 Northern Blvd
Great Neck, NY 11021
Phone (516) 325-7000

270 Park Ave
Huntington, NY 11743
Phone (631) 351-2308

270 Park Ave
Fl 1
Huntington, NY 11743
Phone (631) 351-2219

26901 76th Ave
#344
New Hyde Park, NY 11040

26901 76th Ave
New Hyde Park, NY 11040
Phone (718) 470-3000

1111 Marcus Ave
Ste M15
New Hyde Park, NY 11042
Phone (516) 601-7200

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Organizations & group practices 5

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1861556763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432787",
            "telephone_number": "631-351-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 PARK AVE",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432787",
            "telephone_number": "631-351-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MICHELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "F381711",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.