Active NPI
Brian James Connelly, RN
- Registered Nurse
- San Mateo, CA
National Provider Identifier
1316758014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 95022813
- Practice address
- 1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222 - Phone
- (650) 573-3571
- NPI assigned
- Jan 14, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95022813 | CA | Primary |
Addresses
Primary practice location
1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Mailing address
1950 Alameda de Las Pulgas
San Mateo, CA 94403-1222
Phone (650) 573-3571
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95022813 | CA | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1316758014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 ALAMEDA DE LAS PULGAS",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944031222",
"telephone_number": "650-573-3571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 ALAMEDA DE LAS PULGAS",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944031222",
"telephone_number": "650-573-3571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "BRIAN",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-01-14",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "95022813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.