DR. MARK STEPHEN CONNELLY MD
NPI 1770876583
Pediatrics - Pediatric Critical Care Medicine in Washington, DC
About Dr. Mark Stephen Connelly Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MARK STEPHEN CONNELLY MD (NPI 1770876583) is an individual pediatric critical care medicine provider in Washington, District Of Columbia, licensed in District Of Columbia (MD043066) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Mark Stephen Connelly Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mark Connelly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Washington, DC 20010
- Reassigned Medicare billing, District of Columbia enrollment
- 1,417 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
WASHINGTON, DC 20010
WASHINGTON, DC 20010
WASHINGTON, DC 20010
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 Mark Connelly's NPI number?
The NPI number for Mark Connelly is 1770876583. It was assigned to this individual provider in the NPPES registry on May 26, 2011.
Where is Mark Connelly located?
Mark Connelly practices at 111 Michigan Ave NW Suite M4800, Washington, DC 20010. The listed phone number is (202) 476-6817.
What is Mark Connelly's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.
Is Mark Connelly enrolled in Medicare?
Yes. Mark Connelly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mark Connelly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Connelly reassigns Medicare benefits to Children's Hospital (Washington, DC). 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 Mark Connelly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Connelly was last updated on June 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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. Mark Stephen Connelly, MD · NPI 1770876583
Pediatric Critical Care Medicine physician in Washington, District of Columbia. Individual provider, active in the CMS NPPES registry since May 26, 2011.
## Identity
- **NPI:** 1770876583 (Entity type: Individual)
- **Enumerated:** May 26, 2011
- **Primary specialty:** Pediatrics - Pediatric Critical Care Medicine · taxonomy 2080P0203X
- **State license:** MD043066 (District of Columbia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 111 MICHIGAN AVE NW, SUITE M4800, Washington, DC 20010-2916
- **Phone:** (202) 476-6817
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Children's Hospital (NPI 1780800128, Washington, DC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 15, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1770876583) · Data from the CMS NPPES public registry.