Adrian L Connolly III, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MA036148 Issued in NJ

Practice address

101 Old Short Hills Rd
Ste 503
West Orange, NJ 07052-1023

Phone

(973) 731-9131

Fax

(973) 731-9201

NPI assigned

May 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Rutgers New Jersey Medical School, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Natural Image Skin CenterGroup PAC ID 1557502390, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score

85.75 of 100Reported as group

Quality

76.52

Promoting interoperability

100

Improvement activities

40

Cost

75.97

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karen Lynn Connolly, MD

  • Procedural Dermatology Physician
  • West Orange, NJ
  • NPI 1801116389
  Medicare reassignment

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.

• Natural Image Skin Center

  • Dermatology Physician
  • Hackettstown, NJ
  • NPI 1730427030
  Medicare reassignment Care Compare group NPD
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  Medicare reassignment NPD (past)
• Adrian L. Connolly MD LLC

  • MOHS-Micrographic Surgery Physician
  • West Orange, NJ
  • NPI 1427414556
  NPD (past) Authorized official

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1922001650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S LIVINGSTON AVE STE 1C",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394040",
            "telephone_number": "908-509-1938",
            "fax_number": "856-543-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "STE 503",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521023",
            "telephone_number": "973-731-9131",
            "fax_number": "973-731-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "ADRIAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NJ",
            "license": "MA036148",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NJ",
            "license": "MA036148",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "MA036148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4811801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MA036148",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Danielle Comesanas
• Community Advancement and Transformation
• Comprehensive Medical Group
• Comprehensive Pain Management LLC
• Cleo Concepcion, M.D.
• Karen Lynn Connolly, MD
• Alyssa Leigh Connors
• Consolidated Diagnostic and Imaging PC
• Consultants in Cardiology
• Shamiere Dashaun Contant

• Dermatology Physician in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Dermatology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.