Bonnie Connolly, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

BC082902 Issued in MI

Practice address

Dept la 21069
Pasadena, CA 91185-1069

Phone

(714) 628-3211

Fax

(714) 639-0593

NPI assigned

Apr 14, 2006

Last updated

Dec 13, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Internal Medicine

Education

University of California, Davis School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069
• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• St Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  NPD (past)
• Legacy Emanuel Hospital & Health Center

  dba Legacy Laboratory Services

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898
  NPD (past)
• Livingston Internal Medicine, PC

  • Specialist
  • Howell, MI
  • NPI 1114966587
  NPD (past)
• Medical Office of John Vassallo MD PLLC

  • Internal Medicine Physician
  • Howell, MI
  • NPI 1487712121
  NPD (past)
• Providence Health & Services - Oregon

  dba Providence St. Vincent Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Portland, OR
  • NPI 1285717728
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• St Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1912982216
  Care Compare affiliation
• St. Joseph Hospital of Orange

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Orange, CA
  • NPI 1558575746
  Care Compare affiliation

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1780648725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21069",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851069",
            "telephone_number": "714-628-3211",
            "fax_number": "714-639-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT LA 21069",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851069",
            "telephone_number": "714-628-3211",
            "fax_number": "714-639-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "BONNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "BC082902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4597443",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Conley, PHD
• Rosemary Conn
• Connect Family Counseling, Inc.
• Connections Referral Service (Connections Care Home Consultants)
• Jane G Conner, MSN, NP
• E Lyla James Connolly, APCC
• Cassidy Joelle Connor
• Frank Connors, MS
• Gary Conrad, M.D.
• Constancy Hospice Care Inc

• Specialist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.