Physician Compare National (NPI:1083691885)

HEALTHCARE PROVIDER: MICHAEL JAMES OCONNELL DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1083691885
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678465689
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100106000651
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	OCONNELL
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	JAMES
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	17960 CLEVELAND RD
	Group Practice or individual's line 1 address
City	SOUTH BEND
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	466351349
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT JOSEPH REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150058
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL HOSPITAL OF SOUTH BEND
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230021
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LAKELAND HOSPITAL, ST JOSEPH
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y