NPIMap

Individual provider Active NPI

Dennis W O'Connor, M.D.

  • Family Medicine Physician
  • Bath, NY
National Provider Identifier
1912935743
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
149768 Issued in NY
Practice address
7573 State Route 54
Bath, NY 14810-9504
Phone
(607) 776-2247
Fax
(607) 776-5919
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 149768 NY Primary

Addresses

Primary practice location

7573 State Route 54
Bath, NY 14810-9504

Mailing address

7573 State Route 54
Bath, NY 14810-9504

Other identifiers 1

IdentifierTypeStateIssuer
00708347MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000007 NY Practitioner - Family Practice 3072545300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keuka Family Practice Associates LLPGroup PAC ID 9537191960, 5 clinicians

Practice addresses (Care Compare)

7573 State Route 54
Bath, NY 14810-9504
Phone (607) 776-2247

Hospital & facility affiliations

  • Vna of Western Ny Chha Home health agency, Cheektowaga, NY, CCN 337006
  • Centerwell Home Health Home health agency, Corning, NY, CCN 337292
  • Carefirst / Southern Tier Hospice and Palliative Hospice, Painted Post, NY, CCN 331513
  • Ira Davenport Memorial Hospital Hospital, Bath, NY, CCN 330800
  • Corning Hospital Hospital, Corning, NY, CCN 330277
  • St James Hospital Hospital, Hornell, NY, CCN 330151
  • Arnot Ogden Medical Center Hospital, Elmira, NY, CCN 330090

Merit-based Incentive Payment System (MIPS)

Final score
99.03 of 100Reported as group
Quality
100
Improvement activities
40
Cost
86.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
149768NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Keuka Family Practice Associates LLP Family Medicine CurrentSince May 15, 2001 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

7573 State Route 54
Bath, NY 14810
Phone (607) 776-2247

Interoperability endpoints

  • Direct secure messaging: doconnor4@keukafp.medentdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ira Davenport Memorial Hospital, Inc.Bath, NY, CCN 335706 Skilled nursing facility Corporate Director (6%) Sep 25, 2003

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912935743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7573 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7573 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109504",
            "telephone_number": "607-776-2247",
            "fax_number": "607-776-5919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "DENNIS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "149768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00708347",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.