NPIMap

Individual provider Active NPI

Patrick Connolly, MD

  • Family Medicine Physician
  • Portland, ME
National Provider Identifier
1982655098
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD13573 Issued in ME
Practice address
331 Veranda St
Portland, ME 04103-5545
Phone
(207) 791-3781
Fax
(207) 828-2444
NPI assigned
May 13, 2006
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD13573 ME Primary

Addresses

Primary practice location

331 Veranda St
Portland, ME 04103-5545

Mailing address

PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address patrick.connolly.1@5857.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050706000910 ME Practitioner - Family Practice 8123064615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martin's Point Health Care, Inc.Group PAC ID 5991776635, 91 clinicians

Practice addresses (Care Compare)

331 Veranda St
Portland, ME 04103-5545
Phone (207) 828-2402

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD13573MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin's Point Health Care, Inc. Family Medicine CurrentSince Jul 19, 1993 Accepting new patients
Maine Medical Partners Family Medicine Past Accepting new patients

Locations

6 Farley Rd
Mere Point, ME 04011
Phone (207) 725-8079

331 Veranda St
Portland, ME 04103
Phone (207) 774-5801

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patrick.connolly.1@5857.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1982655098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9746",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045040",
            "telephone_number": "207-791-3888",
            "fax_number": "207-828-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 VERANDA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035545",
            "telephone_number": "207-791-3781",
            "fax_number": "207-828-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD13573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.connolly.1@5857.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "331 Veranda St",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041035545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.