DR. THOMAS JOHN CONNOLLY DDS
NPI 1508905779
Dentist - Periodontics in New York, NY
About Dr. Thomas John Connolly Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. THOMAS JOHN CONNOLLY DDS (NPI 1508905779) is an individual periodontics provider in New York, New York, licensed in New York (032961) and active in the NPI registry since February 2007. He has opted out of Medicare through July 2, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. Thomas John Connolly Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 2, 2015 through July 2, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 10
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10021
NEW YORK, NY 10021
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 1508905779. It was assigned to this individual provider in the NPPES registry on February 5, 2007.
Where is Thomas Connolly located?
Thomas Connolly practices at 654 Madison Ave 1005, New York, NY 10021. The listed phone number is (212) 888-7477.
What is Thomas Connolly's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.
Is Thomas Connolly enrolled in Medicare?
No. Thomas Connolly has opted out of Medicare through July 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
When was this NPI record last updated?
The NPPES record for Thomas Connolly was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dr. Thomas John Connolly, DDS · NPI 1508905779
Periodontics provider in New York, New York. Individual provider, active in the CMS NPPES registry since February 5, 2007.
## Identity
- **NPI:** 1508905779 (Entity type: Individual)
- **Enumerated:** February 5, 2007
- **Primary specialty:** Dentist - Periodontics · taxonomy 1223P0300X
- **State license:** 032961 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 654 MADISON AVE, 1005, New York, NY 10021-8404
- **Phone:** (212) 888-7477 · **Fax:** (212) 758-8451
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 2, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1508905779) · Data from the CMS NPPES public registry.