Individual provider Active NPI

Carol A Connolly, NP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1497944896
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
238901 Issued in MA
Practice address
185 Pilgrim Rd
Baker 4, Cardiology
Boston, MA 02215-5324
Phone
(617) 632-7270
NPI assigned
Oct 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 238901 MA Primary

Addresses

Primary practice location

185 Pilgrim Rd
Baker 4, Cardiology
Boston, MA 02215-5324

Mailing address

17 Emerald St
Quincy, MA 02169-1003
Phone (617) 479-7543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20071130000095 MA Practitioner - Nurse Practitioner 3274622105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Northeastern Ohio University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238901MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 22, 2007 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 13, 2010 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 22, 2007 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jul 13, 2010 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

330 Brookline Ave
#9
Boston, MA 02215
Phone (617) 667-2100

330 Brookline Ave
#72
Boston, MA 02215

185 Pilgrim Rd
Boston, MA 02215
Phone (617) 632-8252

330 Brookline Ave
#7
Boston, MA 02215
Phone (617) 632-7483

185 Pilgrim Rd
#4
Boston, MA 02215
Phone (617) 632-7828

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Interoperability endpoints

  • Direct secure messaging: cconnolly254925@direct.bilh.masshiway.net

Organizations & group practices 5

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 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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1497944896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EMERALD ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021691003",
            "telephone_number": "617-479-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 PILGRIM RD",
            "address_2": "BAKER 4, CARDIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155324",
            "telephone_number": "617-632-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "238901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.