Individual provider Active NPI

Mark William Connolly, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Paterson, NJ
National Provider Identifier
1326010612
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
25MA07436900 Issued in NJ
Practice address
703 Main St
Department of Surgery
Paterson, NJ 07503-2621
Phone
(973) 754-2460
Fax
(973) 754-2462
NPI assigned
Feb 2, 2006
Last updated
Sep 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 25MA07436900 NJ Primary

Addresses

Primary practice location

703 Main St
Department of Surgery
Paterson, NJ 07503-2621

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Other identifiers 2

IdentifierTypeStateIssuer
060268OtherNJMADICARE ID-TYPE UNSPECIFIED
6504906MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA, NE, NY4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20050616000979 NJ Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 8224072566 Reassigns benefits to 2 organizations
I20240502002175 PA Practitioner - Cardiac Surgery 8224072566 Reassigns benefits to 2 organizations
I20240917004302 NE Practitioner - Thoracic Surgery 8224072566 Reassigns benefits to 1 organization
I20241004001565 NY Practitioner - Thoracic Surgery 8224072566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Medical Associates PCGroup PAC ID 0345144978, 229 clinicians
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

30 Harrison St
Suite 250
Johnson City, NY 13790-2176
Phone (607) 763-6580

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2486

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07436900NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Nov 26, 2024 Accepting new patients
St. Joseph Medical Group Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Apr 22, 2024 Accepting new patients
CHI Health Clinic Specialty, LLC CurrentSince Sep 15, 2024 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Aug 5, 2024 Accepting new patients
The Milton S Hershey Medical Center - Physicians Group Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Aug 5, 2024 Accepting new patients
United Medical Associates, P.C. CurrentSince Nov 26, 2024 Accepting new patients
University Physician Associates of New Jersey Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 3, 2025 Accepting new patients
Wellspan Medical Group Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
Cathedral Physician Services, P.C. CurrentSince Apr 1, 2005 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Mar 3, 2025 Accepting new patients
Cathedral Cardiac Specialists, PC Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
St. Joseph Medical Group CurrentSince Apr 22, 2024 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Nov 26, 2024 Accepting new patients
Peachtree Cardiovascular Surgeons at Saint Joseph's LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Richmar Medical Associates Past Accepting new patients
Cardiothoracic Surgical Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients
Peachatree Cardiovascular & Thoracic Surgeons, P.a. PastSince Jul 23, 1992 Accepting new patients
Penn State Health Holy Spirit Medical Center Past Accepting new patients
Advanced Heart Physicians&Surgeons Network PC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

7440 S 91st St
Lincoln, NE 68526
Phone (402) 489-6554

7500 S 91st St
Lincoln, NE 68526
Phone (402) 327-2700

8207 Northwoods Dr
Ste 100
Lincoln, NE 68505
Phone (402) 484-3440

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

30 Harrison St
Ste 250
Johnson City, NY 13790
Phone (607) 763-6580

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

4417 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 729-2144

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

252 S 4th St
Lebanon, PA 17042
Phone (717) 270-7500

252 S 4th St
Fl 2
Lebanon, PA 17042
Phone (717) 270-3751

2494 Bernville Rd
Ste 201
Reading, PA 19605
Phone (610) 378-2557

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1326010612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2460",
            "fax_number": "973-754-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "25MA07436900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MADICARE ID-TYPE UNSPECIFIED",
            "identifier": "060268",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6504906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.