Look up the most recent NPI and PECOS records

Kathy Jean O'Connor

Internal Medicine

Allopathic & Osteopathic Physicians

5150 Journal Center Blvd NE Fl 2, Albuquerque, NM 87109-5900

PECOS Enrollment

Based on the most recent information from CMS, provider Kathy Jean O'Connor does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1679584684
Provider Type
Individual
Full Name
O'Connor, Kathy Jean
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
8/11/2006
Last Updated
9/11/2019

Contact Information

Practice Location

5150 Journal Center Blvd NE Fl 2, Albuquerque, NM 87109-5900

(505) 262-3212

(505) 232-1532

Mailing Location

PO Box 26028, Albuquerque, NM 87125-6028

(505) 262-3212

(505) 232-1532

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License MD2014-0587 New Mexico
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 27775 Arizona

Provider Identifiers

ID	Description	Issuer
ID 480088	Description Medicaid	Issuer Unlisted Arizona
ID 90558235	Description Medicaid	Issuer Unlisted New Mexico
ID 804682	Description Other	Issuer CMS New Mexico

Kathy Jean O'Connor

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Presbyterian Healthcare Services

Hodgin, Ulton G

Coquia, Michael A

Hardwicke, David Mark

Dicarlo, Mary

Internal Medicine Of The Southwest

Near, Torre Donnchadh

Berlin, William Oliver

Russo, James F

Sage Primary Care Clinic