1. Home
  2. Directory
  3. Florida
  4. Jacksonville
  5. Pediatrics
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. THOMAS J CONNOLLY MD05/25
NPI 1093708125
Pediatrics - Adolescent Medicine in Jacksonville, FL

Active since August 24, 2005PECOS Enrolled
2121 PARK ST, JACKSONVILLE, FL 32204(904) 387-6200(904) 387-0261 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas J Connolly Md05/25 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS J CONNOLLY MD05/25 (NPI 1093708125) is an individual adolescent medicine provider in Jacksonville, Florida, licensed in Florida (ME 85592) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093708125
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameDR. THOMAS J CONNOLLYCredential: MD05/25
Location Address2121 PARK STJacksonville, FL 32204-3811
Mailing Address2121 Park StJacksonville, FL 32204-3811 · (904) 387-6200 · Fax (904) 387-0261
Phone(904) 387-6200
Fax(904) 387-0261
Sole ProprietorNo
Enumeration DateAugust 24, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1093708125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in FL · ME 85592
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
2121 PARK ST, Jacksonville, FL 32204
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, AvMed and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas J Connolly Md05/25 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANDREAE AREY SHAW M.D.
Pediatrics
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
MICHELLE C MCCREARY MD
Pediatrics
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
MRS. LETISHA RENEE BRAZILE JEFFERSON MD
Pediatrics
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
LINDSAY J WOLF ARNP
Nurse Practitioner (Pediatrics)
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
ABBY SAPP APRN
Nurse Practitioner (Pediatrics)
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
THE CARITHERS PEDIATRIC GROUP
Pediatrics (Adolescent Medicine)
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
DR. WENDY V SAPOLSKY MD
Pediatrics (Adolescent Medicine)
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200
KIMBERLY TRIPLETT FERGUSON MD
Pediatrics
2121 PARK ST
JACKSONVILLE, FL 32204
Duval County (904) 387-6200

Frequently 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 Thomas Connolly's NPI number?

The NPI number for Thomas Connolly is 1093708125. It was assigned to this individual provider in the NPPES registry on August 24, 2005.

Where is Thomas Connolly located?

Thomas Connolly practices at 2121 Park St, Jacksonville, FL 32204. The listed phone number is (904) 387-6200.

What is Thomas Connolly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Thomas Connolly enrolled in Medicare?

Yes. Thomas Connolly is registered in the Medicare PECOS enrollment system.

What insurance does Thomas Connolly accept?

Health plans from Ambetter Health, Ambetter of Alabama, AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Thomas Connolly 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 Thomas Connolly was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.