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DR. KEVIN O'BRIEN MD
NPI 1003867771
Family Medicine in Rochester, IN

Active since May 15, 2006PECOS EnrolledAccepts Medicare Assignment
47.86/100
CMS Quality Rating
1432 E 9TH ST, ROCHESTER, IN 46975(574) 223-4337(574) 406-9116 Get Directions Write a Review

NPPES record last updated: December 4, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Kevin O'brien Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KEVIN O'BRIEN MD (NPI 1003867771) is an individual family medicine provider in Rochester, Indiana, licensed in Indiana (01036827) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent Kokomo, and maintains a secondary practice location in Logansport.

NPPES Registry Identity

NPI1003867771
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. KEVIN O'BRIENCredential: MD
Location Address1432 E 9TH STRochester, IN 46975-8931
Mailing Address1400 E 9th StRochester, IN 46975-8937 · (574) 224-1048 · Fax (574) 406-9116
Phone(574) 223-4337
Fax(574) 406-9116
Sole ProprietorYes
Medical School CMSIndiana University School Of MedicineGraduated 1984
Enumeration DateMay 15, 2006
Last NPPES UpdateDecember 4, 2025
NPPES CertifiedDecember 4, 2025
✔ NPI 1003867771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01036827
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1432 E 9TH ST, Rochester, IN 46975
Open in Google Maps ↗

Secondary Practice Location 1

Location 12413 High StLogansport, IN 46947-1637 · Phone (574) 732-4609 · Fax (574) 732-1049

Other Identifiers 1

Medicaid100070980IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Kevin O'brien Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800853045
PECOS Enrollment IDI20060612000090
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kevin O'brien reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Woodlawn Hospital
Same address
Orthopaedic Surgery
1430 E 9TH ST
Rochester, IN 46975
  • Reassigned Medicare billing, Indiana enrollment
  • Also billed through NPI 1265413405 (Indiana)
  • 71 clinicians in this Medicare group
NPI 1215569504 (574) 223-9525

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
27 services18 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
19 services18 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension St Vincent Kokomo

Acute Care Hospitals · Kokomo, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150010
Location1907 W Sycamore StKokomo, IN 46904 · Howard County
Emergency services Birthing friendly

Memorial Hospital

Acute Care Hospitals · Logansport, IN
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number150072
Location1101 Michigan AveLogansport, IN 46947 · Cass County
Emergency services Birthing friendly

Woodlawn Hospital

Critical Access Hospitals · Rochester, IN
OwnershipGovernment - Local
CMS Certification Number151313
Location1400 E 9th StRochester, IN 46975 · Fulton County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46975 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

47.86/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.13
Promoting Interoperability0
Improvement Activities40
Cost36.4

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers97 claims247 services$6.34 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
12 suppliers35 claims59 services$1.14 avg. paid by Medicare
Intermittent urinary catheter, with insertion supplies A4353
DME-Orthotic Devices · category DF008N
1 supplier24 claims1,440 services$1.25 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers16 claims16 services$66.04 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
4 suppliers13 claims13 services$21.13 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
3 suppliers13 claims13 services$19.02 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTHONY J. WITT MD
Family Medicine
1432 E 9TH ST
ROCHESTER, IN 46975
Fulton County (574) 223-4337
GINGER M RICHARD
Nurse Practitioner (Family)
1432 E 9TH ST
ROCHESTER, IN 46975
Fulton County (574) 223-4337
MR. MICHAEL J BRUBAKER D.O.
Family Medicine
1432 E 9TH ST
ROCHESTER, IN 46975
Fulton County (574) 223-4337
WOODLAWN HOSPITAL
Clinic/Center (Rural Health)
1432 E 9TH ST
ROCHESTER, IN 46975
Fulton County (574) 223-4337

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kevin O'brien's NPI number?

The NPI number for Kevin O'brien is 1003867771. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Kevin O'brien located?

Kevin O'brien practices at 1432 E 9th St, Rochester, IN 46975. The listed phone number is (574) 223-4337.

What is Kevin O'brien's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kevin O'brien enrolled in Medicare?

Yes. Kevin O'brien is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kevin O'brien's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin O'brien reassigns Medicare benefits to Woodlawn Hospital (Rochester, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kevin O'brien's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin O'brien accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Kevin O'brien as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kevin O'brien affiliated with any hospitals?

According to CMS data, Kevin O'brien is affiliated with Ascension St Vincent Kokomo, Memorial Hospital and Woodlawn Hospital.

When was this NPI record last updated?

The NPPES record for Kevin O'brien was last updated on December 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.