DR. MICHAEL SCOTT CONNOLLY (MD) – Psychiatry Physician, NPI 1003014374
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
256 PSYCHIATRY in UT
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Provider Addresses for DR. MICHAEL SCOTT CONNOLLY (MD)
12391, Pasture Road, Riverton, Salt Lake County, Utah, 84096, United States
RIVERTON, UT 840967012
Phone: (801) 302-1700
Fax: (801) 302-1714
Type: Mailing
2965 W 3500 S
WEST VALLEY CITY, UT 841193602
Phone: (801) 965-3600
Type: Mailing
11724 S STATE ST
DRAPER, UT 840207163
Phone: (801) 965-3600
Type: Location
11724 S State St
Draper, UT 840207163
Phone: (801) 965-3600
Type: Location
700 NE 13TH ST # 38
OKLAHOMA CITY, OK 731045004
Phone: (405) 764-8066
Fax: (405) 271-1001
Type: Mailing
920 STANTON L YOUNG BLVD STE 3240
OKLAHOMA CITY, OK 731045036
Phone: (405) 271-5251
Fax: (405) 271-5759
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 $44.
Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.
Last reported payment date: 2024-02-05 • Largest payer in this snapshot: Corium, LLC ($28).
Total Amount
$44
General + Research + Ownership
Payments
2
Total payment records
General Amount
$44
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $28 |
| IRONSHORE PHARMACEUTICALS INC. | $17 |
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: 2024-09-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080527000583 | I | Psychiatry | UT | TBD |
| I20240909000041 | I | Psychiatry | OK | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84096)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | OK | |
| O P H T H A L M O L O G Y | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| R H E U M A T O L O G Y | OK | |
| Nurse Practitioner | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Certified Registered Nurse Anesthetist (Crna) | OK | |
| Family Practice, Hospitalist | OK | |
| Medical Oncology | RI | |
| Clinical Social Worker | OK |
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