Individual provider Active NPI

Paula Louise Conolly, MD

  • Student in an Organized Health Care Education/Training Program
  • Lafayette, LA
National Provider Identifier
1255530374
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2390 W Congress St
Lafayette, LA 70506-4205
Phone
(337) 261-6000
NPI assigned
Jul 18, 2007
Last updated
Jul 18, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LA Primary

Addresses

Primary practice location

2390 W Congress St
Lafayette, LA 70506-4205

Mailing address

PO Box 69300
QM
Lafayette, LA 70596-9300
Phone (337) 261-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20190925003035 CA Practitioner - Family PracticePractitioner - Other (Physician) 7012109077 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brett V Curtis MD a Professional Corporation IncGroup PAC ID 6507194297, 7 clinicians

Practice addresses (Care Compare)

411 3Rd St
San Rafael, CA 94901-3548
Phone (415) 924-4525

7428 Redwood Blvd
Suite 100
Novato, CA 94945-2419
Phone (415) 895-5216

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brett V. Curtis, MD, a Professional Corporation, Inc. CurrentSince Jul 3, 2019 Accepting new patients

Locations

101 Casa Buena Dr
Corte Madera, CA 94925
Phone (415) 886-4952

7428 Redwood Blvd
Ste 100
Novato, CA 94945
Phone (415) 895-5216

411 3rd St
San Rafael, CA 94901
Phone (415) 854-7159

Organizations & group practices 2

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": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1255530374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69300",
            "address_2": "QM",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705969300",
            "telephone_number": "337-261-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 W CONGRESS ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064205",
            "telephone_number": "337-261-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONOLLY",
        "first_name": "PAULA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.