Deirdre Marie Connolly, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

190888 Issued in NY

Practice address

50 Park Ave
New York, NY 10016-3075

Phone

(212) 679-4134

Fax

(212) 679-7079

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

New York University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Isabelle Ponge Wilson MD PCGroup PAC ID 9335120468, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.54 of 100Reported as group

Quality

99.08

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Isabelle Ponge Wilson MD PC

  • Procedural Dermatology Physician
  • New York, NY
  • NPI 1396866281
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216857600000",
    "number": "1881604700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E 37TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163001",
            "telephone_number": "212-779-9485",
            "fax_number": "646-837-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163075",
            "telephone_number": "212-679-4134",
            "fax_number": "212-679-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "DEIRDRE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "190888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Connolly
• Catherine Mary Connolly, PSY.D
• Christopher Ryan Connolly, MD
• Danielle Connolly
• Deborah Leah Connolly
• Edward Sander Connolly Jr., M.D.
• Eileen Patricia Connolly, M.D.
• Elizabeth Connolly, LMSW
• Erin Lynne Connolly, PMHNP
• James Gregory Connolly

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.