Individual provider Active NPI

Alena Connelly, MD

  • Pediatrics Physician
  • Mineola, NY
National Provider Identifier
1730476821
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
276805 Issued in NY
Practice address
222 Station PLZ N Ste 611
Mineola, NY 11501-3893
Phone
(516) 663-2532
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 276805 NY Primary

Addresses

Primary practice location

222 Station PLZ N Ste 611
Mineola, NY 11501-3893

Mailing address

125 Lincoln Ave Apt B2F
Mineola, NY 11501-2828
Phone (516) 491-1443

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aconnelly239166@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150831001879 NY Practitioner - Pediatric Medicine 5496061871 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
276805NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University Pediatrics CurrentSince Oct 1, 2018 Accepting new patients
NYU Langone Hospitals Past Accepting new patients

Locations

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

222 Station Plz N
Ste 611
Mineola, NY 11501
Phone (516) 663-2532

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: aconnelly239166@nyumc.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1730476821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LINCOLN AVE APT B2F",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012828",
            "telephone_number": "516-491-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893",
            "telephone_number": "516-663-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "ALENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "276805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aconnelly239166@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 Station Plz N Ste 611",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.