Individual provider Active NPI

Matthew F Connolly, M.D.

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1407801996
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
41569020 Issued in WI
Practice address
788 N Jefferson St Ste 300
Milwaukee, WI 53202-3710
Phone
(414) 272-8950
Fax
(414) 272-0859
NPI assigned
May 23, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 41569020 WI Primary

Addresses

Primary practice location

788 N Jefferson St Ste 300
Milwaukee, WI 53202-3710

Mailing address

788 N. Jefferson Street
Suite 300/Attn. Kaaren Butzen
Milwaukee, WI 53202-3710
Phone (414) 272-8950

Other practice location 1

2323 N Lake Dr
Inpatient Medicine
Milwaukee, WI 53211-4508
Phone (414) 270-4932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20060526000078 WI Practitioner - Internal Medicine 9133130487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Madison Medical Affiliates IncGroup PAC ID 5991606337, 86 clinicians

Practice addresses (Care Compare)

788 N Jefferson St
Suite 300
Milwaukee, WI 53202-3710
Phone (414) 272-8950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41569020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary's Hospital Milwaukee, Inc CurrentSince Jul 1, 2008 Accepting new patients
Columbia St. Mary's Hospital Milwaukee Inc CurrentSince Jul 1, 2008 Accepting new patients
Madison Medical Affiliates, Inc. CurrentSince Jun 1, 2017 Accepting new patients

Locations

7423 Solutions Ctr
Chicago, IL 60677

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

788 N Jefferson St
Ste 300
Milwaukee, WI 53202
Phone (414) 272-8950

788 N Jefferson St
Ste 300ATTN
Milwaukee, WI 53202

788 N Jefferson St
Ste 401
Milwaukee, WI 53202
Phone (414) 226-4020

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11299/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1407801996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 N. JEFFERSON STREET",
            "address_2": "SUITE 300/ATTN. KAAREN BUTZEN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023710",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 N JEFFERSON ST STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023710",
            "telephone_number": "414-272-8950",
            "fax_number": "414-272-0859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 N Lake Dr",
            "address_2": "Inpatient Medicine",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532114508",
            "country_code": "US",
            "telephone_number": "414-270-4932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MATTHEW",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "41569020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.