BRANDON LEE O'CONNOR MD
NPI 1053007617
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Q: What is Brandon O'connor's NPI number?

The NPI number for Brandon O'connor is 1053007617. It was assigned to this individual provider in the NPPES registry on April 17, 2023.

Q: What is Brandon O'connor's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Brandon O'connor was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.

Active since April 17, 2023PECOS Enrolled

2450 RIVERSIDE AVE FL M1361, MINNEAPOLIS, MN 55454(612) 624-4477 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2024, May 4, 2023 (2 updates tracked since 2023).

On this page

About Brandon Lee O'connor Md NPPES

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

BRANDON LEE O'CONNOR MD (NPI 1053007617) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053007617

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameBRANDON LEE O'CONNORCredential: MD

Location Address2450 RIVERSIDE AVE FL M1361Minneapolis, MN 55454-1450

Mailing Address2450 Riverside Ave Fl M1361Minneapolis, MN 55454-1450 · (612) 624-4477

Phone(612) 624-4477

Sole ProprietorNo

Enumeration DateApril 17, 2023

Last NPPES UpdateJune 27, 20242 updates tracked since enumeration

NPPES CertifiedJune 27, 2024

✔ NPI 1053007617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2450 RIVERSIDE AVE FL M1361, Minneapolis, MN 55454

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brandon Lee O'connor Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 12

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

SVATAVA MERKLE MD