Active NPI
John F Reilly, MD
- Plastic and Reconstructive Surgery Physician
- Trumbull, CT
National Provider Identifier
1053303818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 040166
- Practice address
- 115 Technology Dr Ste B305
Trumbull, CT 06611-6337 - Phone
- (203) 880-5588
- Fax
- (203) 880-5580
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 040166 | CT | Primary |
Addresses
Primary practice location
115 Technology Dr Ste B305
Trumbull, CT 06611-6337
Mailing address
115 Technology Dr Unit B306
Trumbull, CT 06611-6338
Phone (203) 880-5588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040166 | CT | MD | Plastic and Reconstructive Surgery Physician |
Interoperability endpoints
- john.reilly.1@13008.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Plastic and Reconstructive Surgery Physician
- Trumbull, CT
- NPI 1538249842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1053303818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 TECHNOLOGY DR UNIT B306",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066116338",
"telephone_number": "203-880-5588",
"fax_number": "203-880-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 TECHNOLOGY DR STE B305",
"city": "TRUMBULL",
"state": "CT",
"postal_code": "066116337",
"telephone_number": "203-880-5588",
"fax_number": "203-880-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "JOHN",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "CT",
"license": "040166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Trumbull, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.