Walter Gerard Donnelly Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

018261 Issued in CT

Practice address

29 Hospital Hill Rd
Suite #1100
Sharon, CT 06069

Phone

(860) 364-5646

Fax

(860) 364-5265

NPI assigned

Aug 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164435301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679",
            "city": "SHARON",
            "state": "CT",
            "postal_code": "060690679",
            "telephone_number": "860-364-5646",
            "fax_number": "860-364-5265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HOSPITAL HILL RD",
            "address_2": "SUITE #1100",
            "city": "SHARON",
            "state": "CT",
            "postal_code": "06069",
            "telephone_number": "860-364-5646",
            "fax_number": "860-364-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "WALTER",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CT",
            "license": "018261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "010018261CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "040220",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00508470",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joseph A Dedonato, MD
• Elizabeth Anne Dekker, DDS
• Dixon Orthodontics LLC
• Dutchess Psychology Practice LLC
• Elizabeth Kenney LCSW PLLC
• Essent Healthcare of Connecticut Inc
• Evan P Provisor MD PC (Sharon Surgical Group)
• Expert Pain Management PC

• Ophthalmology Physician in Sharon, CT
• Providers in Sharon, CT by specialty
• Ophthalmology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.