CONNOLLY DERMATOLOGY PHILADELPHIA LLC
NPI 1659976082
Dermatology in Philadelphia, PA

Active since December 03, 2020
2418 E YORK ST, PHILADELPHIA, PA 19125(609) 926-8899(856) 772-1997 Get Directions Write a Review

NPPES record last updated: December 3, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Connolly Dermatology Philadelphia Llc NPPES

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

CONNOLLY DERMATOLOGY PHILADELPHIA LLC (NPI 1659976082) is a healthcare organization registered as a dermatology in Philadelphia, Pennsylvania and active in the NPI registry since December 2020. The organization lists Coyle S Connolly, President, as its authorized official.

NPPES Registry Identity

NPI1659976082
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCONNOLLY DERMATOLOGY PHILADELPHIA LLC
Location Address2418 E YORK STPhiladelphia, PA 19125-3006
Mailing Address2099 New Albany RdCinnaminson, NJ 08077-3534 · (609) 926-8899 · Fax (856) 772-1997
Fax(856) 772-1997
Organization SubpartYesParent: Coyle S Connolly Do Pa
Authorized OfficialCoyle S ConnollyPresident · (609) 926-8899
Enumeration DateDecember 3, 2020
NPPES CertifiedDecember 3, 2020
✔ NPI 1659976082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
2418 E YORK ST, Philadelphia, PA 19125

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Connolly Dermatology Philadelphia Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Connolly Dermatology Philadelphia LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Nurse Practitioner
NPI 1427874767
2418 E YORK ST
Philadelphia, PA 19125
(215) 774-8290
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1235765009
1587 THE FAIRWAY STE C104
Jenkintown, PA 19046
(215) 774-8290
✔ PECOS✔ Accepts Medicare8.9 mi
Nurse Practitioner
NPI 1306718036
9815 ROOSEVELT BLVD STE G
Philadelphia, PA 19114
(215) 774-8290
✔ PECOS✔ Accepts Medicare9.3 mi
Dermatology
NPI 1093040321
20 MEDICAL RIDGE DR
Greenville, SC 29605
(864) 522-5220
✔ PECOS536 mi
Nurse Practitioner
NPI 1023837903
1260 W BAY DR STE C
Largo, FL 33770
(727) 935-0500
✔ PECOS✔ Accepts Medicare940 mi

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

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 Connolly Dermatology Philadelphia LLC's NPI number?

The NPI number for Connolly Dermatology Philadelphia LLC is 1659976082. It was assigned to this organization in the NPPES registry on December 3, 2020.

Where is Connolly Dermatology Philadelphia LLC located?

Connolly Dermatology Philadelphia LLC is located at 2418 E York St, Philadelphia, PA 19125. The listed phone number is (609) 926-8899.

What is Connolly Dermatology Philadelphia LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Connolly Dermatology Philadelphia LLC enrolled in Medicare?

Yes. Connolly Dermatology Philadelphia LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Connolly Dermatology Philadelphia LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Connolly Dermatology Philadelphia LLC. 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 (4) and Dermatology (1). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Connolly Dermatology Philadelphia LLC was last updated on December 3, 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.