Peter J Reilly, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NPP35094 Issued in RI

Practice address

400 Bald Hill Rd
Suite 526
Warwick, RI 02886-1617

Phone

(401) 738-4323

Fax

(401) 738-3857

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Yale University School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Brown Dermatology IncGroup PAC ID 3870872773, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brown Dermatology, Inc.

  • Dermatology Physician
  • Providence, RI
  • NPI 1730538026
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group
• Lifespan Physician Group Inc

  • Urology Physician
  • Providence, RI
  • NPI 1720949803
  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678

  Nurse Practitioner

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1033122098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BALD HILL RD",
            "address_2": "SUITE 526",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861617",
            "telephone_number": "401-738-4323",
            "fax_number": "401-738-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BALD HILL RD",
            "address_2": "SUITE 526",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861617",
            "telephone_number": "401-738-4323",
            "fax_number": "401-738-3857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "PETER",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "NPP35094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "709004108",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025374",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regenmed Ri LLC
• Jared Lee Reichenberg, MD
• Reid Wellness, LLC
• Hannah Reid
• Jessica Grace Reid
• Philip J Reilly, MD
• Andrea Reis, LCDP
• Michael J Rekas, D.O.
• Reliable Respiratory, Inc.
• Britta Renzulli, PA-C

• Nurse Practitioner in Warwick, RI
• Providers in Warwick, RI by specialty
• Nurse Practitioner in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.