William Charles O'Connor Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001011006 Issued in NC

Practice address

11301 Golf Links Dr N Ste 203
Charlotte, NC 28277-8014

Phone

(704) 321-3376

NPI assigned

Feb 8, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Darst Dermatology PCGroup PAC ID 1850441908, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: william.oconnor@dderm.eclinicaldirectplus.com

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.

• Darst Dermatology, PC

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1740434158
  Medicare reassignment Care Compare group
• Charlotte Dermatopathology, Inc

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1558515965
  NPD (past)

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1942892369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 GOLF LINKS DR N STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778014",
            "telephone_number": "704-321-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 GOLF LINKS DR N STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778014",
            "telephone_number": "704-321-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "WILLIAM",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011006",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "001011006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Bailey O'Connor, FNP
• Maeve E O'Connor, MD
• Melissa Elizabeth O'Connor, PA-C
• Rena Arlene O'Connor, PA-C
• Timothy O'Connor, PT, DPT
• Kaela Marie O'Donnell, LCSWA
• Kelly O'Donnell
• Crystal Dawn O'Gorman, LMFT
• Natasha Folda O'Gorman, PA
• Catherine Harte O'Grady, LCSW

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.