Maureen Connolly, MD is a medicare enrolled "Pediatrics" physician in Highland Park, Michigan. Her current practice location is
77 Victor St, Highland Park, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 365-3338.
Maureen Connolly is licensed to practice in Michigan (license number 4301108535) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1629331939.
Physician's Profile
Full Name | Maureen Connolly |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 77 Victor St, Highland Park, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1629331939
- Provider Enumeration Date: 06/21/2012
- Last Update Date: 07/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 5698089381
- Enrollment ID: I20150810001099
Medical Identifiers
Medical identifiers for Maureen Connolly such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629331939 | NPI | - | NPPES |
1629331939 | Medicaid | MI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 4301108535 (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Maureen Connolly allows following entities to bill medicare on her behalf.
Entity Name | Henry Ford Health System |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
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Entity Name | Henry Ford Health System-school Based Health Initiative |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104010578 PECOS PAC ID: 3072875517 Enrollment ID: O20180322000407 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Maureen Connolly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Maureen Connolly, MD 77 Victor St, Highland Park, MI 48203-3127 Ph: (313) 365-3338 | Maureen Connolly, MD 77 Victor St, Highland Park, MI 48203 Ph: (313) 365-3338 |
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