Individual provider Active NPI

Kayden L Reilly, PA-C

  • Physician Assistant
  • Council Bluffs, IA
National Provider Identifier
1043091804
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
122560 Issued in IA
Practice address
800 Mercy Dr
Council Bluffs, IA 51503-3128
Phone
(855) 524-4001
Fax
(712) 325-2499
NPI assigned
Oct 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2995 NE
Physician Assistant 363A00000X 122560 IA Primary

Addresses

Primary practice location

800 Mercy Dr
Council Bluffs, IA 51503-3128

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (855) 524-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231012002072 IA Practitioner - Physician Assistant 8022463918 Reassigns benefits to 1 organization
I20231012002926 NE Practitioner - Physician Assistant 8022463918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians

Practice addresses (Care Compare)

800 Mercy Dr
Council Bluffs, IA 51503-3128

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Oct 10, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Oct 10, 2023 Accepting new patients
Alegent Creighton Clinic CurrentSince Oct 10, 2023 Accepting new patients
Alegent Creighton Clinic Physician Assistant Past Accepting new patients

Locations

800 Mercy Dr
Ste 220
Council Bluffs, IA 51503
Phone (712) 388-2660

800 Mercy Dr
Council Bluffs, IA 51503
Phone (712) 328-5000

2771 Solution Ctr
Chicago, IL 60677

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1043091804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "855-524-4001",
            "fax_number": "712-325-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "855-524-4001",
            "fax_number": "712-325-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "KAYDEN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2995",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "122560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.