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JACK DORSEY O'CONNOR MS, PMHNP
NPI 1962016071
Counselor - Mental Health in Rochester, NY

Active since September 04, 2020PECOS Enrolled
81 LAKE AVE, ROCHESTER, NY 14608(585) 368-6900(585) 368-6996 Get Directions Write a Review

NPPES record last updated: November 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 7, 2022, Sep 4, 2020 (2 updates tracked since 2020).

About Jack Dorsey O'connor Ms, Pmhnp NPPES

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

JACK DORSEY O'CONNOR MS, PMHNP (NPI 1962016071) is an individual mental health provider in Rochester, New York and active in the NPI registry since September 2020. The provider is enrolled in Medicare PECOS and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1962016071
Entity TypeIndividual
Primary Taxonomy101YM0800X
Provider Legal NameJACK DORSEY O'CONNORCredential: MS, PMHNP
Location Address81 LAKE AVERochester, NY 14608-1410
Mailing Address81 Lake AveRochester, NY 14608-1410 · (585) 368-6900 · Fax (585) 368-6996
Phone(585) 368-6900
Fax(585) 368-6996
Sole ProprietorNo
Enumeration DateSeptember 4, 2020
Last NPPES UpdateNovember 1, 20242 updates tracked since enumeration
NPPES CertifiedNovember 1, 2024
✔ NPI 1962016071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License F402984 (NY)
81 LAKE AVE, Rochester, NY 14608
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Secondary Practice Location 1

Location 11099 Jay St Bldg PRochester, NY 14611-1164 · Phone (585) 865-1550 ext. 4

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Dorsey O'connor Ms, Pmhnp 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 20

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

STEPHANIE VEALE DOBBIN LMFT
Marriage & Family Therapist
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900
SHANETTA S WILLIAMS
Counselor (Mental Health)
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900
DAVID REED
Counselor (Addiction (Substance Use Disorder))
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 723-7723
ABBY JUSTINE SMITH
Counselor (Mental Health)
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900
KATHLEEN MARIE AUBERGER LCSW-R
Social Worker (Clinical)
81 LAKE AVE, EVELYN BRANDON HEALTH CENTER
ROCHESTER, NY 14608
Monroe County (585) 368-6900
CARLOS BAHR LMSW
Counselor (Mental Health)
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900
DEANA BECKFORD
Counselor (Addiction (Substance Use Disorder))
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900
LUCAS MICHAEL GLEBER
Counselor (Mental Health)
81 LAKE AVE
ROCHESTER, NY 14608
Monroe County (585) 368-6900

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 Jack O'connor's NPI number?

The NPI number for Jack O'connor is 1962016071. It was assigned to this individual provider in the NPPES registry on September 4, 2020.

Where is Jack O'connor located?

Jack O'connor practices at 81 Lake Ave, Rochester, NY 14608. The listed phone number is (585) 368-6900.

What is Jack O'connor's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jack O'connor enrolled in Medicare?

Yes. Jack O'connor is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack O'connor was last updated on November 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.