Individual provider Active NPI

Kelly Lynne O'Connell, PA

  • Medical Physician Assistant
  • Boston, MA
National Provider Identifier
1932459559
Registry record updated Apr 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5500
Fax
(617) 582-6021
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

46 Pleasantview St
Roslindale, MA 02131-4714
Phone (339) 226-0139

Other names 1

  • Kelly Lynne Shea Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130312000005 MA Practitioner - Physician Assistant 2264687664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

450 Brookline Ave
Boston, MA 02215-5418
Phone (617) 632-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.06 of 100Reported as group
Quality
65.04
Promoting interoperability
100
Improvement activities
40
Cost
69.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Dec 18, 2012 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Dec 18, 2012 Accepting new patients

Locations

450 Brookline Ave
#205
Boston, MA 02215

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

75 Francis St
Boston, MA 02115

Interoperability endpoints

  • Direct secure messaging: oconnell.kellylynne.dfci@direct.partners.masshiway.net

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 2

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": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396396800000",
    "number": "1932459559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 PLEASANTVIEW ST",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021314714",
            "telephone_number": "339-226-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500",
            "fax_number": "617-582-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "KELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2014-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "SHEA",
            "middle_name": "LYNNE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.