Individual provider Active NPI

Jorge Alberto Reiley, MD

  • Neurology Physician
  • Center Moriches, NY
National Provider Identifier
1053487058
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
208448 Issued in NY
Practice address
15 N Ocean Ave
Center Moriches, NY 11934-2320
Phone
(631) 734-7648
Fax
(631) 734-7287
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 208448 NY Primary

Addresses

Primary practice location

15 N Ocean Ave
Center Moriches, NY 11934-2320

Mailing address

1 Oak Ridge CT
Manorville, NY 11949-3240
Phone (631) 379-4149

Other practice location 1

15 N Ocean Ave
Center Moriches, NY 11934-2320
Phone (631) 734-7648

Other identifiers 1

IdentifierTypeStateIssuer
02121002MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041123000071 NY Practitioner - NeurologyPractitioner - Pain Management 7517920622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pain Management
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 N Ocean Ave
Unit 1
Center Moriches, NY 11934-2320
Phone (631) 734-7648

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107

Merit-based Incentive Payment System (MIPS)

Final score
23.36 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
East End Neurology PLLC Neurology CurrentSince Jan 1, 2004 Accepting new patients

Locations

15 N Ocean Ave
Ctr Moriches, NY 11934
Phone (631) 734-7648

15 N Ocean Ave
Unit 1
Ctr Moriches, NY 11934
Phone (631) 734-7648

32645 Route 25
Unit 1
Cutchogue, NY 11935
Phone (631) 734-7648

32645 Main Rd
Cutchogue, NY 11935
Phone (631) 298-7450

Interoperability endpoints

  • Direct secure messaging: jreiley308389@northwell.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1053487058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OAK RIDGE CT",
            "city": "MANORVILLE",
            "state": "NY",
            "postal_code": "119493240",
            "telephone_number": "631-379-4149",
            "fax_number": "631-734-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N OCEAN AVE",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342320",
            "telephone_number": "631-734-7648",
            "fax_number": "631-734-7287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 N Ocean Ave",
            "address_purpose": "LOCATION",
            "city": "Center Moriches",
            "state": "NY",
            "postal_code": "119342320",
            "country_code": "US",
            "telephone_number": "631-734-7648",
            "fax_number": "631-734-7287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILEY",
        "first_name": "JORGE",
        "middle_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "208448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02121002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center Moriches, NY

Sources for this page

Verify at the official NPI Registry.