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BRIAN CONNELLY MD NPI 1124103106


NPI Information

NPI: 1124103106
Provider Name: BRIAN CONNELLY, MD
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
223 N VAN DIEN AVE
RIDGEWOOD, NJ
ZIP 07450
Phone: (201) 847-9403
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Brian Connelly, MD is a specialist in Ridgewood, NJ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Brian Connelly, MD NPI is 1124103106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

223 N VAN DIEN AVE
RIDGEWOOD, NJ
ZIP 07450-726
Phone: (201) 847-9403
Fax: (201) 847-0059

The NPI 1124103106 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)

The enumeration date for this NPI number is 10/26/2006 and was last updated on 7/8/2007.


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
1174400000XSpecialistMA05509500NEW JERSEYYes

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
1F55490MEDICARE UPIN
2742610MEDICARE ID-TYPE UNSPECIFIEDNEW JERSEY

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.