CONNOLLY DERMATOLOGY
NPI 1053367516
Dermatology in Linwood, NJ
About Connolly Dermatology NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CONNOLLY DERMATOLOGY (NPI 1053367516) is a healthcare organization registered as a dermatology in Linwood, New Jersey and active in the NPI registry since May 2006. The organization lists Coyle S Connolly, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Connolly Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
23Medicare enrollment records show 23 clinicians reassign Medicare billing to Connolly Dermatology, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 23Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 31D2070721
Coyle S Connolly, Do PA · Cinnaminson, NJFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Coyle S Connolly Do PA's NPI number?
The NPI number for Coyle S Connolly Do PA is 1053367516. It was assigned to this organization in the NPPES registry on May 26, 2006. The provider is also known as Connolly Dermatology.
Where is Coyle S Connolly Do PA located?
Coyle S Connolly Do PA is located at 2106 New Rd Suite D4, Linwood, NJ 08221. The listed phone number is (609) 926-8899.
What is Coyle S Connolly Do PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Coyle S Connolly Do PA enrolled in Medicare?
Yes. Coyle S Connolly Do PA is registered in the Medicare PECOS enrollment system.
When is Coyle S Connolly Do PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Coyle S Connolly Do PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 23 clinicians in 4 Medicare specialties reassign their Medicare billing to Coyle S Connolly Do PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (19), Dermatology (2) and Pathology (1). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Coyle S Connolly Do PA accept?
Health plans from Oscar Health list Coyle S Connolly Do PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Coyle S Connolly Do PA was last updated on December 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Connolly Dermatology · NPI 1053367516
Dermatology organization in Linwood, New Jersey. Organization record, active in the CMS NPPES registry since May 26, 2006.
## Identity
- **NPI:** 1053367516 (Entity type: Organization)
- **Enumerated:** May 26, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Legal business name:** Coyle S Connolly Do Pa
- **Organization subpart:** No
- **Authorized official:** Coyle Connolly, PRESIDENT
## Practice location
- **Address:** 2106 NEW RD, SUITE D4, Linwood, NJ 08221-1046
- **Phone:** (609) 926-8899 · **Fax:** (609) 926-6474
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 23 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (19), Dermatology (2), Pathology (1); 6 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1053367516/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 2, 2020
- **Other identifiers:** Other DE5501 (NJ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053367516) · Data from the CMS NPPES public registry.