Colleen Chloe McConnell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01520 Issued in RI

Practice address

100 Kenyon Ave
Wakefield, RI 02879-4216

Phone

(401) 782-8000

NPI assigned

Aug 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, RI, CA3 enrollments

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 3

Merit-based Incentive Payment System (MIPS)

Final score

95.47 of 100Reported as group

Quality

85.24

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Emergency Physician Associates of New England PC

  • Emergency Medicine Physician
  • Wakefield, RI
  • NPI 1427381052

  RI

  Medicare reassignment
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment
• Palomar Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Escondido, CA
  • NPI 1124698139

  CA

  Medicare reassignment
• Team Physicians of Southern California Medical Group, Inc.

  • Emergency Medicine Physician
  • Oceanside, CA
  • NPI 1225499015

  CA

  Medicare reassignment

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1740893148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 STARCREST ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928212050",
            "telephone_number": "714-335-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KENYON AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794216",
            "telephone_number": "401-782-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Tebeau St",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315016357",
            "country_code": "US",
            "telephone_number": "912-283-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "COLLEEN",
        "middle_name": "CHLOE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10025",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62655",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vazgen Martirosian, MD
• Lauren E Marvell, NP
• Natalie Nicole Masson, D.P.T.
• Maxi Drug South LP
• Lisa McCarthy
• Emily McCormack, PTA
• Cristina Mota McCormick, M.D.
• James McCormick, DPM
• Deborah McCurdy, LICSW
• Tara McGarty

• All providers in Wakefield, RI
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.
• 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.