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MRS. TIFFANY MARIE CONNOLLY
NPI 1164158580
Physician Assistant - Medical in Moline, IL

Active since July 27, 2022PECOS EnrolledAccepts Medicare Assignment
600 JOHN DEERE RD STE 200, MOLINE, IL 61265(309) 779-4282(309) 779-4303 Get Directions Write a Review

NPPES record last updated: August 5, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 5, 2024, Jul 27, 2022 (2 updates tracked since 2022).

About Mrs. Tiffany Marie Connolly NPPES

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

MRS. TIFFANY MARIE CONNOLLY (NPI 1164158580) is an individual medical provider in Moline, Illinois, licensed in Illinois (085010364) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1164158580
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. TIFFANY MARIE CONNOLLY
Location Address600 JOHN DEERE RD STE 200Moline, IL 61265-6897
Mailing Address600 John Deere Rd Ste 200Moline, IL 61265-6897 · (309) 779-4285 · Fax (309) 779-4303
Phone(309) 779-4282
Fax(309) 779-4303
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 27, 2022
Last NPPES UpdateAugust 5, 20242 updates tracked since enumeration
NPPES CertifiedAugust 5, 2024
✔ NPI 1164158580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IL · 085010364
600 JOHN DEERE RD STE 200, Moline, IL 61265
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Tiffany Marie Connolly is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7012441645
PECOS Enrollment IDI20241105002568
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 8

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

ANNE ELIZABETH NOE PA-C
Physician Assistant
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4285
UNA CLARE MINITER M.D.
Dermatology
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4200
JACOB RILEY HAYLES PA-C
Physician Assistant
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4210
ASHLEE KAYE HOLST D.O.
Internal Medicine
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4200
CARSON MICHELLE DELGADILLO
Physician Assistant
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4310
JUSTIN HINZMAN M.D.
Obstetrics & Gynecology
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4270
RHONDA L FREED MD
Obstetrics & Gynecology
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4200
ELIZABETH RUTA PAREIGIS M.D.
Internal Medicine
600 JOHN DEERE RD STE 200
MOLINE, IL 61265
Rock Island County (309) 779-4225

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 Tiffany Connolly's NPI number?

The NPI number for Tiffany Connolly is 1164158580. It was assigned to this individual provider in the NPPES registry on July 27, 2022.

Where is Tiffany Connolly located?

Tiffany Connolly practices at 600 John Deere Rd Ste 200, Moline, IL 61265. The listed phone number is (309) 779-4282.

What is Tiffany Connolly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tiffany Connolly enrolled in Medicare?

Yes. Tiffany Connolly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tiffany Connolly was last updated on August 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.