Individual provider Active NPI

Margaret Anastasia Connolly, MD

  • Pediatrics Physician
  • Stony Brook, NY
National Provider Identifier
1790942589
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
257913 Issued in NY
Practice address
11 TH Floor Health Sciences Ctr
Stony Brook Children'S Hospital
Stony Brook, NY 11794-8111
Phone
(631) 444-7884
Fax
(631) 444-8968
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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 257913 NY Primary

Addresses

Primary practice location

11 TH Floor Health Sciences Ctr
Stony Brook Children'S Hospital
Stony Brook, NY 11794-8111

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (631) 444-0650

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
I20101019001214 NY Practitioner - Pediatric Medicine 5193918407 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257913NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Pediatrics CurrentSince Aug 16, 2010 Accepting new patients

Locations

2701 Sunrise Hwy
Islip Terrace, NY 11752
Phone (631) 444-6300

Networks

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

Interoperability endpoints

  • Direct secure messaging: margaret.connolly@direct.stonybrookmedicine.edu

Organizations & group practices 1

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1790942589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "631-444-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 TH FLOOR HEALTH SCIENCES CTR",
            "address_2": "STONY BROOK CHILDREN'S HOSPITAL",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948111",
            "telephone_number": "631-444-7884",
            "fax_number": "631-444-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MARGARET",
        "middle_name": "ANASTASIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "257913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.