KEVIN CONNOLLY (DO) – Sports Medicine (Family Medicine) Physician, NPI 1710502182

KEVIN CONNOLLY (DO) is a healthcare provider. based in Augusta, Maine. specializing in FAMILY PRACTICE, SPORTS MEDICINE. They hold the professional credentials DO. They hold a License No. MD27102 (ME). The NPI Number for KEVIN CONNOLLY (DO) is 1710502182

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN CONNOLLY (DO)
NPI
1710502182
Phone
(207) 626-1561
Address
15 E CHESTNUT ST
Enumeration Date
11 June 2020
Last Update Date
12 July 2024

Doctor Profile

Medical School Name
UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
7416370523
Group Practice PAC ID
6406743988
Professional Enrollment ID
I20240808003049
Address ID
NH031094133MA275XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:5State licenses:3Digital endpointsOther names

886 FAMILY PRACTICE in ME

Provider Addresses for KEVIN CONNOLLY (DO)

  • 15 E CHESTNUT ST

    AUGUSTA, ME 043305736

    Phone: (207) 626-1561

    Fax: (207) 626-1849

    Type: Mailing

  • 11 Kimball Dr

    Hooksett, NH 031062603

    Phone: (603) 641-5386

    Type: Location

  • 20 CHAMBERS DR FL 2

    HOOKSETT, NH 031061981

    Phone: (603) 624-8652

    Type: Mailing

  • 20 CHAMBERS DR

    HOOKSETT, NH 031061981

    Phone: (603) 624-8652

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $50.

Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.

Last reported payment date: 2024-04-26 • Largest payer in this snapshot: Pacira Pharmaceuticals Incorporated ($50).

Total Amount

$50

General + Research + Ownership

Payments

2

Total payment records

General Amount

$50

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-26

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2024-08-08

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240808003049IFamily PracticeNHTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04330)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406743988View full group profile
NameSpecialtyState
Family PracticeNH
-NH
Internal MedicineNH
Geriatric Medicine, Internal MedicineNH
-NH
Family PracticeNH
Nurse PractitionerNH
Family Practice, Geriatric MedicineNH
-NH
Internal MedicineAK

Reviews

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Frequently asked questions

How do I look up KEVIN CONNOLLY (DO) by NPI?
Use NPI 1710502182 when you need to reference KEVIN CONNOLLY (DO) in forms, claims, or directories.
Does this profile mean KEVIN CONNOLLY (DO) is currently active?
Yes — KEVIN CONNOLLY (DO) appears active in the national provider directory.
Does KEVIN CONNOLLY (DO) list a primary specialty?
If you are matching referrals, note Sports Medicine (Family Medicine) Physician for KEVIN CONNOLLY (DO). Clinical services aligned with this taxonomy classification.
Does KEVIN CONNOLLY (DO) practice in Maine?
You will see Augusta, Maine on file for KEVIN CONNOLLY (DO) alongside any extra practice locations.
Is KEVIN CONNOLLY (DO) a real provider?
This page reflects official NPPES data for NPI 1710502182. Always confirm identity and privileges with the practice and licensing boards.

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