NPIMap

Individual provider Active NPI

Kelly Connolly

  • Physician Assistant
  • Monroeville, PA
National Provider Identifier
1730423690
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055878 Issued in PA
Practice address
2580 Haymaker Rd Ste 304
Monroeville, PA 15146-3500
Phone
(412) 858-3070
NPI assigned
Nov 16, 2012
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055878 PA Primary

Addresses

Primary practice location

2580 Haymaker Rd Ste 304
Monroeville, PA 15146-3500

Mailing address

2580 Haymaker Rd Ste 304
Monroeville, PA 15146-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kclark51560@direct.ahn.org UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000115 PA Practitioner - Physician Assistant 7214189331 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians
Allegheny Clinic RadiologyGroup PAC ID 8426364738, 153 clinicians

Practice addresses (Care Compare)

2566 Haymaker Rd
Suite 107
Monroeville, PA 15146-3553
Phone (412) 858-4150

2570 Haymaker Rd
Monroeville, PA 15146-3513
Phone (412) 359-6656

320 E N Ave
Pittsburgh, PA 15212-4756

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA055878PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Altoona CurrentSince Apr 3, 2017 Accepting new patients
Allegheny Clinic CurrentSince Feb 24, 2015 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 14, 2012 Accepting new patients
Upmc Altoona CurrentSince Apr 3, 2017 Accepting new patients
Allegheny Clinic CurrentSince Feb 24, 2015 Accepting new patients
University of Pittsburgh Physicians CurrentSince Oct 14, 2012 Accepting new patients
Allegheny Clinic Radiology CurrentSince Jan 21, 2026 Accepting new patients

Locations

620 Howard Ave
Altoona, PA 16601
Phone (814) 889-2011

2570 Haymaker Rd
Monroeville, PA 15146
Phone (412) 858-2000

2580 Haymaker Rd
Ste 304
Monroeville, PA 15146
Phone (412) 578-4341

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

320 E North Ave
Ste 261
Pittsburgh, PA 15212
Phone (412) 359-3901

3471 5th Ave
Ste 1010
Pittsburgh, PA 15213
Phone (412) 605-3254

4800 Friendship Ave
Pittsburgh, PA 15224
Phone (412) 359-3030

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1730423690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 HAYMAKER RD STE 304",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463500",
            "telephone_number": "412-858-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-16",
        "last_updated": "2021-05-21",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kclark51560@direct.ahn.org",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

Verify at the official NPI Registry.