GINA M. CONNOLLY (NP) – Adult Health Nurse Practitioner, NPI 1023364262
Adult Health Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for GINA M. CONNOLLY (NP)
611 E Douglas Rd Ste 207
Mishawaka, IN 465451465
Phone: (574) 647-8800
Fax: (574) 647-8996
Type: Location
900 I St
LA Porte, IN 463505533
Phone: (219) 324-1700
Fax: (219) 324-1602
Type: Location
710 N NILES AVE
SOUTH BEND, IN 466171924
Phone: (574) 647-1610
Fax: (574) 237-6069
Type: Mailing
738 E OAK HILL RD
CHESTERTON, IN 463041360
Phone: (317) 672-5226
Fax: (574) 237-6069
Type: Location
100 NAVARRE PL STE 6600
SOUTH BEND, IN 466011173
Phone: (574) 647-8800
Fax: (574) 647-8896
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $409.
Total Amount is formed as General ($409) + Research ($0) + Ownership ($0) = $409.
Last reported payment date: 2024-12-03 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($125).
Total Amount
$409
General + Research + Ownership
Payments
6
Total payment records
General Amount
$409
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-03
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-10-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20121012000774 | I | Nurse Practitioner | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 94 | 63 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 39 | 39 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 36 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 23 | 23 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 46545)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Cardiovascular Disease (Cardiology), Interventional Cardiology | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| Qualified Audiologist | IN | |
| - | IN | |
| Nurse Practitioner | IN | |
| - | IN | |
| General Surgery | IN | |
| - | IN | |
| Nurse Practitioner | IN |
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