KATHLEEN CONNOLLY NP NPI 1043284417

NPI Information

NPI: 1043284417
Provider Name: KATHLEEN CONNOLLY, NP
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
133 BROOKLINE AVE
BOSTON, MA
ZIP 02215
Phone: (617) 421-1000
Get Directions

Kathleen Connolly, NP is a pediatrics nurse practitioner in Boston, MA. Kathleen Connolly, NP NPI is 1043284417. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

133 BROOKLINE AVE
BOSTON, MA
ZIP 02215-904
Phone: (617) 421-1000
Fax: (617) 421-6084

The NPI 1043284417 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/14/2006 and was last updated on 5/2/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		152188	MASSACHUSETTS	No
2	363LP0200X	Nurse Practitioner	Pediatrics	152188	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AA34079	OTHER	MASSACHUSETTS	HARVARD PILGRIM
2	NP9605	OTHER	MASSACHUSETTS	BLUE CROSS
3	NP5050	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS
4	Q45608	MEDICARE UPIN	MASSACHUSETTS
5	0704369	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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