Individual provider Active NPI

Caroline O'Connell, N.P.

  • Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1992995195
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN268759 Issued in MA
Practice address
19 Dodge St
Beverly, MA 01915-1705
Phone
(978) 927-0060
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 268759 MA
Nurse Practitioner 363L00000X RN268759 MA Primary

Addresses

Primary practice location

19 Dodge St
Beverly, MA 01915-1705

Mailing address

19 Dodge St
Beverly, MA 01915-1705
Phone (845) 527-9720

Other practice location 1

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8380

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070927000690 MA Practitioner - Nurse Practitioner 4981799525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Israel Lahey Health Primary Care, IncGroup PAC ID 7719291434, 351 clinicians

Practice addresses (Care Compare)

1350 Market St
Lynnfield, MA 01940-4048
Phone (781) 213-4050

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

305 Gloucester Crossing Rd
Gloucester, MA 01930-2283
Phone (978) 304-8380

Hospital & facility affiliations

  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

Merit-based Incentive Payment System (MIPS)

Final score
85.9 of 100Reported as group
Quality
82.55
Improvement activities
40
Cost
84.99

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN268759MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Oct 22, 2023 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Oct 22, 2023 Accepting new patients

Locations

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: coconnell231161@direct.bilh.masshiway.net

Organizations & group practices 2

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 3

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": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1992995195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151705",
            "telephone_number": "845-527-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151705",
            "telephone_number": "978-927-0060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Maple St",
            "address_purpose": "LOCATION",
            "city": "Danvers",
            "state": "MA",
            "postal_code": "019234065",
            "country_code": "US",
            "telephone_number": "978-304-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "CAROLINE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "268759",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN268759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.