KEVIN MATTHEW O'CONNOR (PA-C) – Physician Assistant, NPI 1225407539

KEVIN MATTHEW O'CONNOR (PA-C) is a healthcare provider. based in Great lakes, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 0010-06001 (NC). The NPI Number for KEVIN MATTHEW O'CONNOR (PA-C) is 1225407539

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN MATTHEW O'CONNOR (PA-C)
NPI
1225407539
Phone
Not provided
Address
3420 ILLINOIS ST
Enumeration Date
16 September 2015
Last Update Date
26 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9107544441
Graduation Year
2015 (11 years ago)
PAC ID
7214270511
Group Practice PAC ID
1153234893
Professional Enrollment ID
I20251121004083
Address ID
NC284703405SH5145XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness85
Years active:10State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

Provider Addresses for KEVIN MATTHEW O'CONNOR (PA-C)

  • 3420 ILLINOIS ST

    GREAT LAKES, IL 600883161

    Phone:

    Type: Mailing

  • 509 OLDE WATERFORD WAY

    LELAND, NC 284514125

    Phone: (704) 293-8836

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $128.

Total Amount is formed as General ($128) + Research ($0) + Ownership ($0) = $128.

Last reported payment date: 2024-09-26 • Largest payer in this snapshot: LEO Pharma Inc. ($128).

Total Amount

$128

General + Research + Ownership

Payments

4

Total payment records

General Amount

$128

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
LEO Pharma Inc.$128
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251121004083IPhysician AssistantNCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60088)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153234893View full group profile

Reviews

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Frequently asked questions

Does KEVIN MATTHEW O'CONNOR (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KEVIN MATTHEW O'CONNOR (PA-C) uses 1225407539.
Does the file indicate KEVIN MATTHEW O'CONNOR (PA-C) is practicing under active NPI?
Directory data currently reports KEVIN MATTHEW O'CONNOR (PA-C) as active.
What taxonomy line describes KEVIN MATTHEW O'CONNOR (PA-C)?
For research purposes, treat KEVIN MATTHEW O'CONNOR (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect KEVIN MATTHEW O'CONNOR (PA-C) on a map?
Expect Great Lakes, Illinois as a primary anchor for KEVIN MATTHEW O'CONNOR (PA-C) unless the record lists multiple sites.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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