Michael Charles Connell, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002970 Issued in NY

Practice address

3 Irongate Ctr
Glens Falls, NY 12801-3471

Phone

(518) 793-4409

Fax

(518) 615-0140

NPI assigned

Dec 6, 2007

Sex

Male

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Irongate Family Practice Associates PLLC

  • Family Medicine Physician
  • Glens Falls, NY
  • NPI 1851326326

  NY

  Medicare reassignment
• Saratoga Hospital

  • Endocrinology, Diabetes & Metabolism Physician
  • Gansevoort, NY
  • NPI 1033371166

  NY

  Medicare reassignment
• Saratoga Hospital

  • Community/Retail Pharmacy
  • Saratoga Springs, NY
  • NPI 1164148110
  NPD
• Saratoga Hospital

  • Family Medicine Physician
  • Ballston Lake, NY
  • NPI 1437418795
  NPD
• Scotia Glenville Family Medicine, P.C.

  • Family Medicine Physician
  • Ballston Lake, NY
  • NPI 1619922218
  NPD

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1568645083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WEST AVE STE 103",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666052",
            "telephone_number": "518-583-0111",
            "fax_number": "518-583-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 IRONGATE CTR",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013471",
            "telephone_number": "518-793-4409",
            "fax_number": "518-615-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "002970",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Work and Independence, Inc.
• Community, Work, and Independence, Inc.
• Keith A Compson, MS PT
• April Cone, LMSW, CASAC
• Conifer Park, Inc.
• Thomas P Connelly
• Alexis Conroy, MSW
• John Coombes, MD
• Sereena C Coombes, MD
• Elizabeth J Cooney, MD

• All providers in Glens Falls, NY
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.