Jack Dorsey O'Connor, MS, PMHNP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

81 Lake Ave
Rochester, NY 14608-1410

Phone

(585) 368-6900

Fax

(585) 368-6996

NPI assigned

Sep 4, 2020

Sex

Unspecified or another gender identity

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• University of Rochester

  • Community/Retail Pharmacy
  • Rochester, NY
  • NPI 1598476269
  NPD
• University of Rochester

  • Internal Medicine Physician
  • Rochester, NY
  • NPI 1710226824
  NPD
• University of Rochester

  • General Practice Dentistry
  • Rochester, NY
  • NPI 1982787537
  NPD
• Villa of Hope

  • Voluntary or Charitable Agency
  • Rochester, NY
  • NPI 1578640298
  NPD

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1962016071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900",
            "fax_number": "585-368-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 LAKE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146081410",
            "telephone_number": "585-368-6900",
            "fax_number": "585-368-6996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1099 Jay St Bldg P",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146111164",
            "country_code": "US",
            "telephone_number": "585-865-1550 x4",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "JACK",
        "middle_name": "DORSEY",
        "credential": "MS, PMHNP",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2020-09-04",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F402984",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann O'Connell, PHYSICIAN ASSISTANT
• Rebecca O'Connell, MD
• Anne Elizabeth O'Connor, M.S.
• Brendan C. O'Connor, MD
• Daniel Turpin O'Connor, MD
• Jessica Claire O'Connor, PA
• John James O'Connor, PT, DPT
• Kate O'Connor, D.O.
• Lauren O'Connor
• Lauren Kathryn O'Connor

• Mental Health Counselor in Rochester, NY
• Providers in Rochester, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.