Andrew J Connolly, PT, OCS, FAAOMPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5392-024 Issued in WI

Practice address

951 Main St Ste 120
Union Grove, WI 53182-1074

Phone

(800) 974-4378

Fax

(630) 515-1536

NPI assigned

Jul 24, 2006

Last updated

Feb 20, 2023By the provider in NPPES

Sex

Male

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 WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DPT Holdings LLCGroup PAC ID 4688679293, 170 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602

  WI

  Medicare reassignment Care Compare group NPD
• Chad Novasic PT LTD

  dba Alliant Physical Therapy Group

  • Physical Therapist
  • Racine, WI
  • NPI 1578679890
  NPD (past)
• Sports Physical Therapy & Rehab Specialists, S.C.

  dba Athletico Physical Therapy

  • Physical Therapist
  • Kenosha, WI
  • NPI 1326150624
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1891717229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24014 W RENWICK RD UNIT 206",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605448711",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 MAIN ST STE 120",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531821074",
            "telephone_number": "800-974-4378",
            "fax_number": "630-515-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "PT, OCS, FAAOMPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5392-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40306500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Buisse, MS, LPC
• Lana R. Buttke, NP
• Brandon Kevin Caldwell
• Jerry Lee Ceilesh, D.D.S.
• Trisha Commodore, RN
• Amanda Marie Czajkowski, MS, MHP
• Gerald A Demers, MD
• Lauren Devries
• Drlullaby LLC
• Jenna Dundas

• Physical Therapist in Union Grove, WI
• Providers in Union Grove, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.