Individual provider Active NPI

Maria R O'Brien, MD

  • Family Medicine Physician
  • Bristol, CT
National Provider Identifier
1992718068
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
038427 Issued in CT
Practice address
61 Bradley St
Suite7
Bristol, CT 06010-5103
Phone
(860) 314-6898
Fax
(860) 314-6896
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 038427 CT Primary

Addresses

Primary practice location

61 Bradley St
Suite7
Bristol, CT 06010-5103

Mailing address

61 Bradley St.
Suite7
Bristol, CT 06010
Phone (860) 314-6898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050928000133 CT Practitioner - Family Practice 0547295651

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
038427CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gary Miller MD LLC PastSince Sep 30, 2015 Accepting new patients
MHS Primary Care Inc Family Medicine Past Accepting new patients
East Haddam Medical Associate,PC Family Medicine Past Accepting new patients

Organizations & group practices 3

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1992718068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 BRADLEY ST.",
            "address_2": "SUITE7",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "860-314-6898",
            "fax_number": "860-314-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BRADLEY ST",
            "address_2": "SUITE7",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105103",
            "telephone_number": "860-314-6898",
            "fax_number": "860-314-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "038427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.