Individual provider Active NPI

Kevin Connolly

  • Otolaryngology Physician
  • Owings Mills, MD
National Provider Identifier
1104352764
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0095991 Issued in MD
Practice address
23 Crossroads Dr Ste 400
Owings Mills, MD 21117-5490
Phone
(410) 356-2626
NPI assigned
May 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0095991 MD Primary

Addresses

Primary practice location

23 Crossroads Dr Ste 400
Owings Mills, MD 21117-5490

Mailing address

2002 Medical Pkwy Ste 230
Annapolis, MD 21401-3282
Phone (410) 266-3900

Other practice location 1

10025 Governor Warfield Pkwy Ste 101
Columbia, MD 21044-3308
Phone (410) 356-2626

Other practice location 2

5233 King Ave Ste 112
Rosedale, MD 21237-4003
Phone (410) 356-2626

Other practice location 3

410 Malcolm Dr Ste E
Westminster, MD 21157-6160
Phone (410) 356-2626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606001166 MD Practitioner - Otolaryngology 5991044455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Louisville School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Annapolis ENT Surgical Center LLCGroup PAC ID 9436226750, 41 clinicians
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

23 Crossroads Dr
Suite 400
Owings Mills, MD 21117-5490
Phone (410) 356-2626

3701 N Charles St
South Chapman Building Suite 102
Towson, MD 21204-6808

6535 N Charles St
Baltimore, MD 21204-5829

6565 N Charles St
Baltimore, MD 21204-6808

6569 N Charles St
Suite 505
Baltimore, MD 21204-6808
Phone (443) 849-2658

6569 N Charles St PPW Room
307 GYN Specialists
Baltimore, MD 21204-6808
Phone (443) 849-6123

6569 N Charles Street
504 Hoover Low Vision GBMC
Baltimore, MD 21204-6808
Phone (443) 849-2658

6701 N Charles St
Baltamore, MD 21204-6808

6701 N Charles St BLDG
S Chapman BLDG Suite 102
Baltimore, MD 21204-6808

6701 N Charles St Unit
Baltimore, MD 21204-6808
Phone (443) 849-3131

Hospital & facility affiliations

  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
85.51
Promoting interoperability
100
Improvement activities
40
Cost
65.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0095991MDMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Annapolis ENT Surgical Center LLC CurrentSince Jul 1, 2024 Accepting new patients
Annapolis ENT Surgical Center, LLC Past Accepting new patients

Locations

2002 Medical Pkwy
Ste 230
Annapolis, MD 21401
Phone (410) 226-3900

10025 Governor Warfield Pkwy
Ste 101
Columbia, MD 21044
Phone (410) 356-2626

10400 Little Patuxent Pkwy
Ste 300
Columbia, MD 21044
Phone (410) 356-2626

23 Crossroads Dr
Ste 400
Owings Mills, MD 21117
Phone (410) 356-2626

5233 King Ave
Ste 112
Rosedale, MD 21237
Phone (410) 238-0057

6535 N Charles St
Ste 250
Towson, MD 21204
Phone (443) 849-2140

410 Malcolm Dr
Ste E
Westminster, MD 21157
Phone (410) 356-2626

Organizations & group practices 5

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1104352764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 230",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013282",
            "telephone_number": "410-266-3900",
            "fax_number": "888-223-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR STE 400",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175490",
            "telephone_number": "410-356-2626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10025 Governor Warfield Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210443308",
            "country_code": "US",
            "telephone_number": "410-356-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5233 King Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Rosedale",
            "state": "MD",
            "postal_code": "212374003",
            "country_code": "US",
            "telephone_number": "410-356-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 Malcolm Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576160",
            "country_code": "US",
            "telephone_number": "410-356-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-02",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0095991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.