Individual provider Active NPI

Megan Marie Connolly, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1497401491
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704423811 Issued in MI
Practice address
5050 NE Hoyt St Ste 315
Portland, OR 97213-2982
Phone
(503) 215-8580
NPI assigned
Feb 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 202203236NP-PP OR
Family Nurse Practitioner 363LF0000X 4704423811 MI Primary
Registered Nurse 163W00000X 439398 OH

Addresses

Primary practice location

5050 NE Hoyt St Ste 315
Portland, OR 97213-2982

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

3555 W 13 Mile Rd Ste N120
Royal Oak, MI 48073-6710
Phone (855) 863-8761

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mconnolly3237828@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220511002499 OR Practitioner - Nurse Practitioner 5092192146 Reassigns benefits to 1 organization
I20250530002998 MI Practitioner - Nurse Practitioner 5092192146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

3555 W 13 Mile Rd
Royal Oak, MI 48073-6710

3577 W 13 Mile Rd
Royal Oak, MI 48073-6710

3581 W 13 Mile Rd BCC
Beaumont Breast Care Center
Royal Oak, MI 48073-6710
Phone (248) 551-3300

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
439398OHMDRegistered Nurse
4704423811MIMDFamily Nurse Practitioner
202203236NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Jun 1, 2022 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 1, 2022 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince May 8, 2025 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3555 W 13 Mile Rd
Ste N120
Royal Oak, MI 48073
Phone (248) 551-1550

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

4805 NE Glisan St
Ste 3E14
Portland, OR 97213

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Interoperability endpoints

  • Direct secure messaging: mconnolly3237828@epic00.corewelldirect.org

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 and National Provider Directory roles.

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": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1497401491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST STE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132982",
            "telephone_number": "503-215-8580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3555 W 13 Mile Rd Ste N120",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736710",
            "country_code": "US",
            "telephone_number": "855-863-8761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202203236NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704423811",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "439398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mconnolly3237828@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "3555 W 13 Mile Rd Ste N120",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.