Individual provider Active NPI

Michael A O'Connor, PCNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Cruz, CA
National Provider Identifier
1881736338
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95007718 Issued in CA
Practice address
1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone
(831) 454-4100
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X RN230451 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN230451 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95007718 CA Primary

Addresses

Primary practice location

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Mailing address

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone (831) 454-4100

Other practice location 1

2025 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 423-4111

Other practice location 2

115A Coral St
Santa Cruz, CA 95060-2131
Phone (831) 454-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180830001930 CA Practitioner - Nurse Practitioner 0547438632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of Santa CruzGroup PAC ID 7618872912, shared by 4 NPIs, 65 clinicians

Practice addresses (Care Compare)

1080 Emeline Ave
Health Services Agency FQHC Santa Cruz Clin
Santa Cruz, CA 95060-1966
Phone (831) 454-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95007718CAMDPsychiatric/Mental Health Nurse Practitioner
RN230451MAMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Cruz Current Accepting new patients
County of Santa Cruz CurrentSince Feb 4, 2020 Accepting new patients
County of Santa Cruz CurrentSince Feb 4, 2020 Accepting new patients

Locations

115A Coral St
Santa Cruz, CA 95060
Phone (831) 454-2080

1080 Emeline Ave
Santa Cruz, CA 95060
Phone (831) 454-4100

1430 Freedom Blvd
Ste D
Watsonville, CA 95076
Phone (831) 763-8400

Interoperability endpoints

  • Direct secure messaging: moconnor297246@direct.ochin.org

Organizations & group practices 3

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1881736338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-454-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2025 Soquel Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "95062",
            "country_code": "US",
            "telephone_number": "831-423-4111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115A Coral St",
            "address_purpose": "LOCATION",
            "city": "Santa Cruz",
            "state": "CA",
            "postal_code": "950602131",
            "country_code": "US",
            "telephone_number": "831-454-2080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PCNS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN230451",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN230451",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95007718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.