Individual provider Active NPI

Tara Reilly, D.O.

  • Emergency Medicine Physician
  • Hudson, OH
National Provider Identifier
1063628600
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
58.001676 Issued in OH
Practice address
7777 Alexandra Dr
Hudson, OH 44236-4523
Phone
(440) 225-8197
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58001676 OH
Emergency Medicine Physician 207P00000X 58.001676 OH Primary

Addresses

Primary practice location

7777 Alexandra Dr
Hudson, OH 44236-4523

Mailing address

7777 Alexandra Dr
Hudson, OH 44236-4523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100505000642 OH Practitioner - Emergency MedicinePractitioner - Family Practice 7719015114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allen Emergency Physicians LLCGroup PAC ID 9739554379, 13 clinicians

Practice addresses (Care Compare)

200 W Lorain St
Oberlin, OH 44074-1026
Phone (440) 775-1211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.62 of 100Reported as group
Quality
71.63
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.001676OHMDEmergency Medicine Physician
58001676OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Lorain Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

Organizations & group practices 2

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.

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1063628600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 ALEXANDRA DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 ALEXANDRA DR",
            "city": "HUDSON",
            "state": "OH",
            "postal_code": "442364523",
            "telephone_number": "440-225-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "TARA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58001676",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58.001676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, OH

Sources for this page

Verify at the official NPI Registry.