Samantha Connolly, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

025569 Issued in NY

Practice address

8043 212TH St
Queens Village, NY 11427-1014

Phone

(718) 551-7105

NPI assigned

Jan 23, 2017

Last updated

Jun 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group
• Ny Speech Pathology Consultants, P.C.

  • Speech-Language Pathologist
  • Locust Valley, NY
  • NPI 1285976324
  Medicare reassignment NPD
• North Shore Center for Speech, Language & Swallowing Disorders

  • Speech-Language Pathologist
  • Garden City, NY
  • NPI 1023476090
  NPD
• North Shore Center for Speech, Language & Swallowing Disorders LLP

  • Early Intervention Provider Agency
  • Garden City, NY
  • NPI 1457595472
  NPD

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1114464534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 HOLIDAY PARK DR",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932542",
            "telephone_number": "718-551-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8043 212TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114271014",
            "telephone_number": "718-551-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pauline Colquhoun-Edwards, RN
• John W Comeau, DPT
• Compact Learning Services
• Compass Point Mental Health Counseling, PC
• Connect Physical Therapy P.C.
• Evelyn Jenita Connor, RN
• Eusebe Constantin, MD
• Ashley Cooley
• Josephine Corda
• Ryan Cordero, MD

• Speech-Language Pathologist in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.