Nikotah Connolly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062247 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-3100

Phone

(570) 271-6298

Fax

(570) 271-5841

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, CO2 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 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Catholic Health Initiatives Colorado

  dba Ctsa Cardiac Thor Surg

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
  • NPI 1356783351
  Medicare reassignment Care Compare group
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Wilkes Barre, PA
  • NPI 1629681150
  NPD
• Catholic Health Initiatives Colorado

  dba Mosu Med Onc Summit

  • Medical Oncology Physician
  • Frisco, CO
  • NPI 1700258050
  NPD
• Catholic Health Initiatives Colorado

  dba CommonSpirit Orthopedics Longmont

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD
• Catholic Health Initiatives Colorado

  dba NSSH Neurosurg Sah

  • Neurological Surgery Physician
  • Lakewood, CO
  • NPI 1205846664
  NPD (past)

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

• Catholic Health Initiatives Colorado

  dba Penrose Cardiac & Pulmonary Rehab Center

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1801436415
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba Penrose Hospital

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1932112125
  Care Compare affiliation

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1902452428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223100",
            "telephone_number": "570-271-6298",
            "fax_number": "570-271-5841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6031 E Woodmen Rd Ste 250Go",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809232623",
            "country_code": "US",
            "telephone_number": "719-571-8660",
            "fax_number": "719-571-8661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "NIKOTAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0008282",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bradley Darren Confer, D.O.
• Andrew R Conger, M.D.
• Kylie Connell, AU.D.
• Mary A. Connell, CRNP
• James Connolly, PA-C
• Alexa Anne Connors, PA-C
• David Connuck, MD
• Elizabeth Conrad
• Deanna Lynn Contreras, PHARMD
• Danielle Lynn Cook, FNP-C

• Physician Assistant in Danville, PA
• Providers in Danville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.