Individual provider Active NPI

Michael John O'Connor, O.D.

  • Optometrist
  • Horseheads, NY
National Provider Identifier
1962701763
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
007670 Issued in NY
Practice address
298 Colonial Dr
Horseheads, NY 14845-8400
Phone
(607) 796-6284
Fax
(607) 796-6617
NPI assigned
Mar 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5600760 NY
Optometrist 152W00000X 007670 NY Primary

Addresses

Primary practice location

298 Colonial Dr
Horseheads, NY 14845-8400

Mailing address

298 Colonial Dr
Horseheads, NY 14845-8400
Phone (607) 796-6284

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110621000099 NY Practitioner - Optometry 1557549698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plow Optometry PCGroup PAC ID 7517044886, 4 clinicians

Practice addresses (Care Compare)

298 Colonial Dr
Horseheads, NY 14845-8400
Phone (607) 796-6284

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5600760NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Plow Optometry PC Optometrist CurrentSince Jun 2, 2011 Accepting new patients

Locations

298 Colonial Dr
Horseheads, NY 14845
Phone (607) 796-6284

140 Village Sq
Painted Post, NY 14870
Phone (607) 796-6284

143 Village Sq
#101
Painted Post, NY 14870
Phone (607) 796-6284

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1962701763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 COLONIAL DR",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458400",
            "telephone_number": "607-796-6284",
            "fax_number": "607-796-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 COLONIAL DR",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458400",
            "telephone_number": "607-796-6284",
            "fax_number": "607-796-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "5600760",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "007670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

Verify at the official NPI Registry.