Robert Michael Connolly, PT, DPT, MBA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26885 Issued in MD

Practice address

4470 Regency PL Ste 100
White Plains, MD 20695-3085

Phone

(301) 645-6680

NPI assigned

Jun 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration

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 and National Provider Directory roles.

• Adams County Physical Therapy Limited Partnership

  • Physical Therapist
  • Hanover, PA
  • NPI 1306879507
  Medicare reassignment NPD

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1306226527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N ALABAMA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327242309",
            "telephone_number": "301-848-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 REGENCY PL STE 100",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953085",
            "telephone_number": "301-645-6680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 N Boundary Ave",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327203173",
            "country_code": "US",
            "telephone_number": "386-738-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30358",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in White Plains, MD
• Providers in White Plains, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.