Individual provider Active NPI

Carla Connelly, PA-C

  • Surgical Physician Assistant
  • Worcester, MA
National Provider Identifier
1578898797
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA3801 Issued in MA
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(508) 363-6095
NPI assigned
Oct 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3801 MA
Surgical Physician Assistant 363AS0400X PA3801 MA Primary

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

9 Industrial Rd
Ste 5
Milford, MA 01757-3736
Phone (508) 473-1480

Other practice location 1

14 Prospect St
Milford, MA 01757-3003
Phone (508) 473-1480

Other identifiers 1

IdentifierTypeStateIssuer
110181302AMedicaidMA

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
I20091103000281 MA Practitioner - Physician Assistant 5890833388 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians
Milford Regional Physician Group, Inc.Group PAC ID 5597679449, 219 clinicians

Practice addresses (Care Compare)

14 Prospect St
Milford, MA 01757-3003
Phone (508) 473-1190

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

68 A Main St
Medway, MA 02053-1775

Hospital & facility affiliations

  • Milford Regional Medical Center Hospital, Milford, MA, CCN 220090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3801MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Milford Regional Physician Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Milford Regional Physician Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Saint Vincent Physician Services, Inc. Physician Assistant PastSince Aug 23, 2020 Accepting new patients

Locations

68A Main St
Ste 101
Medway, MA 02053
Phone (508) 533-6020

9 Industrial Rd
Ste 5
Milford, MA 01757
Phone (508) 473-1480

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 6

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 1

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1578898797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 INDUSTRIAL RD",
            "address_2": "STE 5",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017573736",
            "telephone_number": "508-473-1480",
            "fax_number": "508-473-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-6095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017573003",
            "country_code": "US",
            "telephone_number": "508-473-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "CARLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-06",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3801",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA3801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110181302A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.