Individual provider Active NPI

Claire Marie Connolly

  • Physical Therapist
  • Queensbury, NY
National Provider Identifier
1740016203
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
053019-01 Issued in NY
Practice address
2 Country Club Rd
Queensbury, NY 12804-2115
Phone
(518) 926-2000
Fax
(518) 926-2020
NPI assigned
Sep 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 053019-01 NY Primary

Addresses

Primary practice location

2 Country Club Rd
Queensbury, NY 12804-2115

Mailing address

2 Country Club Rd
Queensbury, NY 12804-2115
Phone (518) 926-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250124000594 VT Practitioner - Physical Therapist in Private Practice 3274062930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vermont Sports Medicine CenterGroup PAC ID 2365334810, 14 clinicians

Practice addresses (Care Compare)

190 S Main St
Suite 1
Rutland, VT 05701-4812
Phone (802) 775-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053019-01NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Vermont Sports Medicine Center Physical Therapist CurrentSince Jan 21, 2025 Accepting new patients
Vermont Sports Medicine Center CurrentSince Jan 21, 2025 Accepting new patients

Locations

190 S Main St
#1
Rutland, VT 05701
Phone (802) 775-1300

Organizations & group practices 2

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": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1740016203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COUNTRY CLUB RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042115",
            "telephone_number": "518-926-2000",
            "fax_number": "518-926-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COUNTRY CLUB RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042115",
            "telephone_number": "518-926-2000",
            "fax_number": "518-926-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "CLAIRE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "053019-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.