Individual provider Active NPI

Brian Connelly, MD

  • Anesthesiology Physician
  • Shrewsbury, NJ
National Provider Identifier
1124103106
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA05509500 Issued in NJ
Practice address
655 Shrewsbury Ave
Shrewsbury, NJ 07702-4179
Phone
(732) 264-1127
NPI assigned
Oct 26, 2006
Last updated
Feb 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA05509500 NJ Primary

Addresses

Primary practice location

655 Shrewsbury Ave
Shrewsbury, NJ 07702-4179

Mailing address

PO Box 188
Little Silver, NJ 07739-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070515000020 NJ Practitioner - Anesthesiology 8628967130 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
313741NYMDLicensed Practical Nurse
25MA05509500NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Toms River Ambulatory Anesthesia LLC Anesthesiology CurrentSince Aug 8, 2023 Accepting new patients
Shrewsbury Ambulatory Anesthesia LLC Anesthesiology CurrentSince Aug 8, 2023 Accepting new patients
Toms River Ambulatory Anesthesia LLC Anesthesiology CurrentSince Aug 8, 2023 Accepting new patients
Bergen Anesthesia Associates PA Specialist Past Accepting new patients

Locations

655 Shrewsbury Ave
Shrewsbury, NJ 07702
Phone (732) 450-6000

1430 Hooper Ave
Toms River, NJ 08753
Phone (732) 240-2277

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1124103106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077390188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 SHREWSBURY AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024179",
            "telephone_number": "732-264-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA05509500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

Verify at the official NPI Registry.