Sean G Connolly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901003864 Issued in MI

Practice address

21780 21 Mile Rd
Macomb, MI 48044-2974

Phone

(586) 242-7761

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Shelby Township, MI
  • NPI 1639723596
  Medicare reassignment NPD
• Myeyedr Optometry of Michigan, LLC

  • Optometrist
  • Clarkston, MI
  • NPI 1215753553
  NPD
• Robert G Mobley MD PC

  • Ophthalmology Physician
  • Clinton Township, MI
  • NPI 1386724771
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1316980394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21780 21 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442974",
            "telephone_number": "586-421-2020",
            "fax_number": "586-421-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21780 21 MILE RD",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442974",
            "telephone_number": "586-242-7761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SEAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clements Chiropractic Clinic, Inc.
• CNS Healthcare
• Cobblestone Ridge Dentistry
• Complete Rehab Services, Inc
• Comprehensive Foot & Ankle Health, P.C.
• Taylor R. Consiglio
• Consulting Geeks LLC
• Justin Conway, LPN
• Craig Arthur Cooper, R.PH
• Cornerstone Therapy LLC

• Optometrist in Macomb, MI
• Providers in Macomb, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.