Thomas John Connolly, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

032961 Issued in NY

Practice address

654 Madison Ave
1005
New York, NY 10021-8404

Phone

(212) 888-7477

Fax

(212) 758-8451

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 2, 2015 through Jul 2, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508905779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 MADISON AVE",
            "address_2": "1005",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100218404",
            "telephone_number": "212-888-7477",
            "fax_number": "212-758-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 MADISON AVE",
            "address_2": "1005",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100218404",
            "telephone_number": "212-888-7477",
            "fax_number": "212-758-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "032961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Connolly, MD
• Philippa Connolly, PHD
• Shannon Connolly, DC
• Shanon M Connolly, M.D.
• Thomas Connolly, PT, DPT
• Bradley A Connor, MD
• Sharon Lerner Connor, LMSW MSED.
• Anthony John Connors, LMHC
• Bali Connors, PA-C
• Frank Patrick Connors, PH.D.

• Periodontics in New York, NY
• Providers in New York, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.