Individual provider Active NPI

Mary Irene Oconnor, M.D.

  • Orthopaedic Surgery Physician
  • Jacksonville Beach, FL
National Provider Identifier
1891785713
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME59025 Issued in FL
Practice address
3205 Ocean Dr S
Jacksonville Beach, FL 32250-5956
Phone
(904) 607-8348
NPI assigned
Oct 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME59025 FL Primary

Addresses

Primary practice location

3205 Ocean Dr S
Jacksonville Beach, FL 32250-5956

Mailing address

3205 Ocean Dr S
Jacksonville Beach, FL 32250-5956
Phone (904) 607-8348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA, CA, ND, AK5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20100204000488 FL Practitioner - Orthopedic Surgery 6608942065 Reassigns benefits to 1 organization
I20240212002659 MA Practitioner - Physical Medicine and Rehabilitation 6608942065 Reassigns benefits to 1 organization
I20240213002967 CA Practitioner - Orthopedic Surgery 6608942065 Reassigns benefits to 1 organization
I20240308001701 ND Practitioner - Orthopedic Surgery 6608942065 Reassigns benefits to 1 organization
I20240416003913 AK Practitioner - Orthopedic Surgery 6608942065

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME59025FLMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vori Medical PLLC CurrentSince Feb 4, 2024 Accepting new patients
Vori Health Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Vori Health Medical Group PLLC CurrentSince Jan 30, 2024 Accepting new patients

Locations

2035 Corte del Nogal
Carlsbad, CA 92011
Phone (909) 764-4360

2710 Gateway Oaks Dr
Ste 150N
Sacramento, CA 95833
Phone (817) 966-0621

1111 SE Federal Hwy
Ste 330
Stuart, FL 34994
Phone (561) 556-7248

1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233

84 State St
Boston, MA 02109
Phone (855) 777-2244

418 N 2nd St
Bismarck, ND 58501
Phone (701) 224-8783

100 Powell Pl
#1441
Nashville, TN 37204

Organizations & group practices 4

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": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1891785713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 OCEAN DR S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505956",
            "telephone_number": "904-607-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 OCEAN DR S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505956",
            "telephone_number": "904-607-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNOR",
        "first_name": "MARY",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-22",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME59025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.