Individual provider Active NPI

Kaitlin Ann O'Connor, D.O.

  • Obstetrics & Gynecology Physician
  • Weymouth, MA
National Provider Identifier
1962841254
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
280740 Issued in MA
Practice address
90 Libbey Pkwy Ste 105
Weymouth, MA 02189-3129
Phone
(339) 201-4120
Fax
(339) 201-4122
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101020663 MI
Obstetrics & Gynecology Physician 207V00000X 56357 CT
Obstetrics & Gynecology Physician 207V00000X 280740 MA Primary

Addresses

Primary practice location

90 Libbey Pkwy Ste 105
Weymouth, MA 02189-3129

Mailing address

90 Libbey Pkwy Ste 105
Weymouth, MA 02189-3129
Phone (339) 201-4120

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191002001145 MA Practitioner - Obstetrics/Gynecology 4486883568 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Kansas City University of Physicians and Surgeons, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians

Practice addresses (Care Compare)

51 Performance Dr
Weymouth, MA 02189-3141
Phone (781) 624-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.58 of 100Reported as group
Quality
58.14
Promoting interoperability
74
Improvement activities
40
Cost
72.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56357CTMDObstetrics & Gynecology Physician
280740MAMDObstetrics & Gynecology Physician
5101020663MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth OB-GYN, PC CurrentSince Sep 1, 2019 Accepting new patients
South Shore Medical Center, Inc. Obstetrics & Gynecology CurrentSince Mar 1, 2023 Accepting new patients
South Shore Hospital Inc. Past Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc PastSince Nov 15, 2021 Accepting new patients

Locations

1 Brookline Pl
Ste 305
Brookline, MA 02445
Phone (617) 232-3030

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

118 Long Pond Rd
Plymouth, MA 02360
Phone (508) 747-6762

1495 Hancock St
Quincy, MA 02169
Phone (617) 745-4100

90 Libbey Park
Ste 105
Weymouth, MA 02189
Phone (339) 201-4120

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

51 Performance Dr
Weymouth, MA 02189
Phone (781) 337-5555

689 Bedford St
Whitman, MA 02382
Phone (781) 447-4001

Organizations & group practices 4

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 1

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1962841254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 LIBBEY PKWY STE 105",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893129",
            "telephone_number": "339-201-4120",
            "fax_number": "339-201-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 LIBBEY PKWY STE 105",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893129",
            "telephone_number": "339-201-4120",
            "fax_number": "339-201-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "KAITLIN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101020663",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "56357",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "280740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.