Andrew Donnelly

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

299385 Issued in CA

Practice address

445 Maple St
Palo Alto, CA 94301-2219

Phone

(866) 839-6979

NPI assigned

Nov 18, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1083217434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17801 DONMETZ ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444013",
            "telephone_number": "424-346-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 MAPLE ST",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012219",
            "telephone_number": "866-839-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martin Louis Donaldson
• Emily Dong, PA-C
• Jenine Samantha Dong, PHARMD
• Kathleen Julia Dong, MD
• Kimberly Dong, PHARM.D.
• Penny Donnelly, RN MFT
• Julia Rachel Donner, MD
• Mackenzie Donovan
• Lori Lynn Doran-Garcia, DDS
• Jennifer Dore, MD

• Physical Therapist in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.