Shaun Patrick O'Connell, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

024709-01 Issued in NY

Practice address

134 Smith Ave
Holbrook, NY 11741-1147

Phone

(631) 605-9925

NPI assigned

Feb 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

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

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.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment Care Compare group
• Internal Medicine Solutions P.C.

  • Internal Medicine Physician
  • Woodside, NY
  • NPI 1467821694
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center

  • Psychiatric Hospital Unit
  • Rockville Centre, NY
  • NPI 1427017854
  Care Compare affiliation
• Mercy Medical Center

  • Rehabilitation Hospital Unit
  • Rockville Centre, NY
  • NPI 1598724924
  Care Compare affiliation
• Mercy Medical Center

  • General Acute Care Hospital
  • Rockville Centre, NY
  • NPI 1659330173
  Care Compare affiliation

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1912530916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 SMITH AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411147",
            "telephone_number": "631-605-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 SMITH AVE",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411147",
            "telephone_number": "631-605-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "SHAUN",
        "middle_name": "PATRICK",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "024709-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby J Noghrey, DO
• North Shore University Hospital Manhasset
• Michael Nussbaum, M.D.
• Nutrition Thyme, LLC
• Karen Ann O Mahony
• Jennifer Obijuru, OT
• Joanne I Oconnor, LCSW SOCIAL WORKER
• Michael Joseph Oconnor
• James Eric Oliver
• On Site Mobile Opticians Inc

• Physician Assistant in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.