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DR. KEVIN PATRICK CONNOLLY M.D.
NPI 1215314257
Pediatrics in Salem, OR

Active since April 28, 2015PECOS Enrolled
2400 LANCASTER DR NE, SALEM, OR 97305(800) 813-2000 Get Directions Write a Review

NPPES record last updated: March 11, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 11, 2026, Feb 4, 2022, Oct 24, 2018 and 2 more (5 updates tracked since 2018).

About Dr. Kevin Patrick Connolly M.d. NPPES

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

DR. KEVIN PATRICK CONNOLLY M.D. (NPI 1215314257) is an individual pediatrics provider in Salem, Oregon, licensed in Oregon (MD192844) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Fresno.

NPPES Registry Identity

NPI1215314257
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. KEVIN PATRICK CONNOLLYCredential: M.D.
Location Address2400 LANCASTER DR NESalem, OR 97305-1221
Mailing Address500 Ne Multnomah St Ste 100Portland, OR 97232-2031
Phone(800) 813-2000
Sole ProprietorNo
Enumeration DateApril 28, 2015
Last NPPES UpdateMarch 11, 20265 updates tracked since enumeration
NPPES CertifiedMarch 11, 2026
✔ NPI 1215314257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in OR · MD192844✔ Licensed in CA · A153322
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2400 LANCASTER DR NE, Salem, OR 97305
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Secondary Practice Location 1

Location 12823 Fresno StFresno, CA 93721-1324 · Phone (559) 459-6000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Patrick Connolly M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Kevin Connolly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Salem Rehabilitation, LLC
5.1 mi
Skilled Nursing Facility
3445 BOONE RD SE
Salem, OR 97317
  • Reassigned Medicare billing, Oregon and Washington enrollments
  • Medicare enrollment name: Kaiser Foundation Health Plan Of The Northwest
  • Also billed through NPI 1871848457 (Washington)
  • 3,207 clinicians in this Medicare group
NPI 1215071998 (503) 576-3000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$97.16 typical visit price
range $17.68 – $136.19
Typical copayment $24.29 (range $4.42 – $34.04)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
Clinical Medical Laboratory
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 370-4909
DR. KRYSTYNA ANTONINA PEKALSKA M.D.
Internal Medicine
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 361-5400
MARY M SELF ABOC
Technician/Technologist (Optician)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 370-4851
ELLANY CHRISTINA ADAMS LCSW
Social Worker (Clinical)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 361-5400
ALISON J GREEN MSN, FNP-C
Nurse Practitioner (Family)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 361-5400
OANH NGUYEN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (866) 280-1563
MR. JAMES D BARGER M.S.N., A.N.P.
Nurse Practitioner (Occupational Health)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (888) 414-3531
TAD YOUNG
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
2400 LANCASTER DR NE
SALEM, OR 97305
Marion County (866) 280-1563

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 Kevin Connolly's NPI number?

The NPI number for Kevin Connolly is 1215314257. It was assigned to this individual provider in the NPPES registry on April 28, 2015.

Where is Kevin Connolly located?

Kevin Connolly practices at 2400 Lancaster Dr NE, Salem, OR 97305. The listed phone number is (800) 813-2000.

What is Kevin Connolly's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kevin Connolly enrolled in Medicare?

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

Which organization bills Medicare for Kevin Connolly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Connolly reassigns Medicare benefits to South Salem Rehabilitation, LLC (Salem, OR). The 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 Kevin Connolly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Connolly accept?

Health plans from Kaiser Permanente list Kevin 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 Kevin Connolly was last updated on March 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.