NPIMap

Organization Active NPI

Reilley Physical Therapy, PLLC

  • Physical Therapist
  • Freeville, NY
National Provider Identifier
1003425968
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
REILLEY PHYSICAL THERAPY, PLLC
Practice address
625 West Dryden Rd
Freeville, NY 13068-9746
Phone
(607) 319-2480
Fax
(607) 261-1190
NPI assigned
Jul 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anne Marie Reilley, PT, DPTNPI 1225431786
Title
Managing Member, Owner
Phone
(607) 319-2480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X

Addresses

Primary practice location

625 West Dryden Rd
Freeville, NY 13068-9746

Mailing address

625 W Dryden Rd
Freeville, NY 13068-9746
Phone (607) 319-2480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200914001382 NY Part B Supplier - Clinic/Group Practice 6608294269 Receives reassigned benefits from 5 practitioners
Practice locations: Freeville, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1003425968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W DRYDEN RD",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689746",
            "telephone_number": "607-319-2480",
            "fax_number": "607-261-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 WEST DRYDEN RD",
            "city": "FREEVILLE",
            "state": "NY",
            "postal_code": "130689746",
            "telephone_number": "607-319-2480",
            "fax_number": "607-261-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REILLEY PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "REILLEY",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGING MEMBER, OWNER",
        "authorized_official_telephone_number": "607-319-2480",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.