DR. IAN DAVID CONNOLLY MD
NPI 1851954309
Student in an Organized Health Care Education/Training Program in Boston, MA

Active since April 19, 2019PECOS Enrolled
55 FRUIT ST, WHITE 5-502, BOSTON, MA 02114(617) 726-5143 Get Directions Write a Review

NPPES record last updated: April 19, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Ian David Connolly Md NPPES

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

DR. IAN DAVID CONNOLLY MD (NPI 1851954309) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851954309
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. IAN DAVID CONNOLLYCredential: MD
Location Address55 FRUIT ST, WHITE 5-502Boston, MA 02114-2696
Mailing Address360 Forest Ave Apt 602Palo Alto, CA 94301-2527 · (949) 295-5784
Sole ProprietorNo
Enumeration DateApril 19, 2019
NPI 1851954309 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
55 FRUIT ST, Boston, MA 02114

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Ian David Connolly Md 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.

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.

Pathology (Anatomic Pathology)
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Hematology & Oncology)
55 FRUIT ST
BOSTON, MA 02114
Anesthesiology
55 FRUIT ST, GRAY-BIGELOW 444
BOSTON, MA 02114
Physical Medicine & Rehabilitation
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Infectious Disease)
55 FRUIT ST, DIVISION OF INFECTIOUS DISEASE, GRJ-504
BOSTON, MA 02114
Nurse Practitioner (Acute Care)
55 FRUIT ST, BIGALOW 852 F
BOSTON, MA 02114
Nurse Practitioner
55 FRUIT ST
BOSTON, MA 02114
Internal Medicine (Cardiovascular Disease)
55 FRUIT ST
BOSTON, MA 02114

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 Ian Connolly's NPI number?

The NPI number for Ian Connolly is 1851954309. It was assigned to this individual provider in the NPPES registry on April 19, 2019.

Where is Ian Connolly located?

Ian Connolly practices at 55 Fruit St White 5-502, Boston, MA 02114. The listed phone number is (617) 726-5143.

What is Ian Connolly's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ian Connolly enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Ian Connolly was last updated on April 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.