Timothy Gerard Connelly, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DO-390 Issued in RI

Practice address

825 Chalkstone Ave
Providence, RI 02908-4728

Phone

(401) 456-2666

Fax

(401) 456-2196

NPI assigned

Mar 6, 2007

Last updated

Jan 8, 2019By the provider in NPPES

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 RI, MA2 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 2

Specialty

AnesthesiologyAlso: Interventional Pain Management

Education

University of New England, College of Osteo Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Narragansett Bay Anesthesia LLCGroup PAC ID 5991774929, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roger Williams Medical Center Hospital, Providence, RI, CCN 410004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Narragansett Bay Anesthesia, LLC

  • Anesthesiology Physician
  • Warwick, RI
  • NPI 1861445728

  MA

  Medicare reassignment Care Compare group NPD
• Steward Medical Group, Inc

  • Anesthesiology Physician
  • Fall River, MA
  • NPI 1043711914
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD
• Southern New England Anesthesia and Pain Associates, Inc

  • Anesthesiology Physician
  • Pawtucket, RI
  • NPI 1356394407
  NPD (past)

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

• Prospect Chartercare RWMC, LLC

  dba Roger Williams Medical Center

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1013332014
  Care Compare affiliation

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1407986631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON ST",
            "address_2": "STE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902324",
            "telephone_number": "401-490-7530",
            "fax_number": "401-490-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2666",
            "fax_number": "401-456-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "TIMOTHY",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "77171",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "RI",
            "license": "DO-390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Conley
• Madison Conley, MHCA
• Lauren Caroline Connell
• William Daniel Connell III
• Stacey Gordon Connelly, OTRL CHT
• Amanda Connerton, PSYD
• Gina M Connerton, MLP-NP
• Julie Connolly, LCSW
• William Joseph Connolly
• Caitlin Connor

• Anesthesiology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Anesthesiology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.
• 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.