DR. SKY B CONNOLLY (NPI# 1194710442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194710442 |
| Entity Type | Individual |
| Full Name | DR. SKY B CONNOLLY |
| Credential | MD |
| Practice Address |
5310 Homestead Rd Ne Suite 301 Albuquerque NM 87110-1437 |
| Practice Telephone | 5058724700 |
| Practice Fax Number | 5058724709 |
| Mailing Telephone | 5058724700 |
| Mailing Fax Number | 5058724709 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2011-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 2000166 | NM | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
2000166 | NM | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
2000166 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | BCBS | NM009032 | 01 |
| MC RR | 070015106 | 01 |
| Street Address |
5310 HOMESTEAD RD NE SUITE 301 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-1437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518403492 | Pamela O Moore | Counselor | 5310 Homestead Rd Ne, Suite 300, Albuquerque, NM 87110-1437 | 2017-01-16 |
| 1184096190 | Gary Lee Joseph Giron | Counselor | 5310 Homestead Rd Ne, Albuquerque, NM 87110-1437 | 2015-10-29 |
| 1821467374 | Erica A Montoya | Counselor | 5310 Homestead Rd Ne, Suite 300, Albuquerque, NM 87110-1437 | 2015-09-15 |
| 1306238324 | Tree of Life Massage and Wellness LLC | Massage Therapist | 5310 Homestead Rd Ne, Suite 202a, Albuquerque, NM 87110-1437 | 2015-02-27 |
| 1376739052 | Teri M Rolan | Pharmacist | 5310 Homestead Rd Ne, Albuquerque, NM 87110-1437 | 2007-09-17 |
| 1740485275 | Suraj Gopal Reddy | Dermatology | 5310 Homestead Rd Ne, Suite 301, Albuquerque, NM 87110-1437 | 2007-06-15 |
| 1316079973 | Carol Lynn Hunter | Nurse Practitioner | 5310 Homestead Rd Ne, Albuquerque, NM 87110-1437 | 2007-03-09 |
| 1639218639 | Shilpa Gopal Reddy | Specialist | 5310 Homestead Rd Ne, Suite 301, Albuquerque, NM 87110-1437 | 2007-02-06 |
| 1790886240 | Robert Campbell Jones | Chiropractor | 5310 Homestead Rd Ne, Bldg 400, Albuquerque, NM 87110-1437 | 2006-09-26 |
| 1235238387 | Aaron Bernd Kaufman | General Practice | 5310 Homestead Rd Ne, Bldg 400, Albuquerque, NM 87110-1437 | 2006-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124024880 | David A. Davis | Dermatology | 6200 Uptown Blvd Ne Ste 410, Albuquerque, NM 87110-4161 | 2005-06-27 |
| 1174653299 | Western Dermatology Consultants PC | Dermatology | 10151 Montgomery Blvd Ne, Bldg. 1 Ste. A, Albuquerque, NM 87111-3670 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003975699 | Diane M. Reisinger | Dermatology | 2019 Galisteo St Ste N9b, Santa Fe, NM 87505 | 2006-12-08 |
| 1104378314 | Desert Mountain Skin Cancer Surgery, LLC | Dermatology | 2019 Galisteo Street, Suite N-9b, Santa Fe, NM 87505 | 2016-11-04 |
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on DR. SKY B CONNOLLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.