Charles William Connolly, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1784 Issued in MA

Practice address

120 College Ave
Somerville, MA 02144-1919

Phone

(617) 776-2500

Fax

(617) 776-3850

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Shore Medical Center - Hospital, Salem, MA, CCN 220035
• Massachusetts General Hospital Hospital, Boston, MA, CCN 220071

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Family Foot Care Group Inc

  • Foot & Ankle Surgery Podiatrist
  • Swampscott, MA
  • NPI 1093913691
  Medicare reassignment NPD Authorized official
• N. Robert Nunberg

  dba The Foot Doctor

  • Podiatrist
  • East Boston, MA
  • NPI 1215073242
  NPD (past)

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

• North Shore Medical Center, Inc.

  dba Salem Hospital

  • General Acute Care Hospital
  • Salem, MA
  • NPI 1730121633
  Care Compare affiliation
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Care Compare affiliation

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1932105095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 COLLEGE AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441919",
            "telephone_number": "781-593-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COLLEGE AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441919",
            "telephone_number": "617-776-2500",
            "fax_number": "617-776-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MA",
            "identifier": "Y70860",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "709158",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361968",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "33386",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2700037",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret G Compher, LICSW
• Comprehensive Dental Care
• Kathleen Conkey, RN
• Bridget Conlon
• Barbara Jean Connolly, RN
• Joseph J Connors, MSW
• Patricia Contente, MSW, LICSW
• David Conway, OD
• Casey Boyea Cook, D.M.D.
• Heather Cook

• Podiatrist in Somerville, MA
• Providers in Somerville, MA by specialty
• Podiatrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.