NPIMap

Individual provider Active NPI

Peter Connolly, MD

  • Vascular Surgery Physician
  • New York, NY
National Provider Identifier
1104066356
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
243565 Issued in NY
Practice address
525 E 68TH St
Payson-7
New York, NY 10065-4870
Phone
(212) 746-0421
Fax
(212) 746-5812
NPI assigned
Mar 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 243565 NY Primary

Addresses

Primary practice location

525 E 68TH St
Payson-7
New York, NY 10065-4870

Mailing address

525 E 68TH St
Payson-7
New York, NY 10065-4870
Phone (212) 746-0421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110712000406 NY Practitioner - General SurgeryPractitioner - Vascular Surgery 8921276239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
University of California, Irvine, California College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, shared by 46 NPIs, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
New York, NY 10065-4870
Phone (212) 746-2157

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2898

Hospital & facility affiliations

  • VNS of Ny Home Care Chha Home health agency, New York, NY, CCN 337008
  • Americare Certified Special Services, Inc Chha Home health agency, Brooklyn, NY, CCN 337290
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion28
Leg revascularization (restoring blood flow)45
Removal of tissue12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2011 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2011 Accepting new patients
Weill Medical College of Cornell Current Accepting new patients
Weill Medical College of Cornell CurrentSince Oct 1, 2012 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

5645 Main St
Flushing, NY 11355
Phone (718) 670-1435

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

525 E 68th St
#7
New York, NY 10065
Phone (212) 746-0421

50 E 69th St
New York, NY 10021
Phone (212) 570-4000

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: pec9018@direct.nyp.org
  • Direct secure messaging: pconnolly38652@mskcc.direct-ci.com
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1235865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1104066356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "address_2": "PAYSON-7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-0421",
            "fax_number": "212-746-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E 68TH ST",
            "address_2": "PAYSON-7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100654870",
            "telephone_number": "212-746-0421",
            "fax_number": "212-746-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-01",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "243565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.