Rebecca Connelly, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0003595 Issued in CO

Practice address

3501 S Shields St
Fort Collins, CO 80526-2583

Phone

(970) 490-2020

NPI assigned

Jun 29, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO, IL2 enrollments

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 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carr Eye Professionals PCGroup PAC ID 4981591963, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Carr Eye Professionals PC

  • Optometrist
  • Orland Park, IL
  • NPI 1396866323
  Medicare reassignment Care Compare group
• Gregory a. Vosseteig P.C.

  • Clinic/Center
  • Fort Collins, CO
  • NPI 1912052523
  NPD

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1467079137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 DES MOINES DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805256686",
            "telephone_number": "815-931-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 S SHIELDS ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805262583",
            "telephone_number": "970-490-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17200 S McCarron Rd",
            "address_purpose": "LOCATION",
            "city": "Homer Glen",
            "state": "IL",
            "postal_code": "604918260",
            "country_code": "US",
            "telephone_number": "815-931-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "0003595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF REGULATORY AGENCIES",
            "identifier": "0003595",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connected Care
• Connected Hearts Counseling, PLLC
• Kara Ann Connell
• Kathlin Jean Connell
• Janet L Connelly, PMHNP-BC
• Sabrina Connelly, LMHC
• Bradley T Conner, PH.D.
• Jill Conner
• Kendra Renee Conner, DC
• Cody Connor

• Optometrist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Optometrist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.