DR. MARK ANDREW CONNELLY (PHD) – Psychologist, NPI 1407874753

DR. MARK ANDREW CONNELLY (PHD) is a healthcare provider. based in Kansas city, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. LP1679 (KS). The NPI Number for DR. MARK ANDREW CONNELLY (PHD) is 1407874753

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK ANDREW CONNELLY (PHD)
NPI
1407874753
Phone
(816) 701-5200
Address
2401 GILLHAM RD
Enumeration Date
17 July 2006
Last Update Date
22 December 2025

Doctor Profile

Medical School Name
UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
Secondary Phone
8162343000
Graduation Year
2004 (22 years ago)
PAC ID
2961401344
Group Practice PAC ID
2466366026
Professional Enrollment ID
I20061212000656
Address ID
MO641084619KA2401XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness85
Years active:19State licenses:2Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

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Provider Addresses for DR. MARK ANDREW CONNELLY (PHD)

  • Children's Mercy Hospital, 2401, Gillham Road, Kansas City, Jackson County, Missouri, 64108, United States

    ATTN PROVIDER ENROLLMENT DEPT

    KANSAS CITY, MO 641084619

    Phone: (816) 701-5200

    Fax: (816) 302-9939

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-12-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20061212000656IClinical PsychologistMOTBD
I20141224000934IClinical PsychologistKSTBD

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 64108)

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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: 2466366026View full group profile
NameSpecialtyState
Diagnostic Radiology, Radiation OncologyMO
Pediatric MedicineTX
Anesthesiology, Cardiovascular Disease (Cardiology)KS
-MO
Diagnostic RadiologyMO
Urology, Pediatric MedicineMO
Diagnostic RadiologyMO
Pediatric Medicine, Emergency MedicineMO
-MO
-IA

Reviews

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Frequently asked questions

What identifier follows DR. MARK ANDREW CONNELLY (PHD) across health systems?
The NPI 1407874753 uniquely identifies DR. MARK ANDREW CONNELLY (PHD) in U.S. healthcare data.
Is DR. MARK ANDREW CONNELLY (PHD) currently accepting referrals based on NPI status?
Registry metadata lists DR. MARK ANDREW CONNELLY (PHD) as active.
Which specialty label fits DR. MARK ANDREW CONNELLY (PHD)?
NPPES ties DR. MARK ANDREW CONNELLY (PHD) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit DR. MARK ANDREW CONNELLY (PHD) in Kansas City, Missouri?
For routing, start with Kansas City, Missouri for DR. MARK ANDREW CONNELLY (PHD), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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