Jacqueline Anne Reilley, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP031312 Issued in PA

Practice address

4162 Apple St
Philadelphia, PA 19127-1620

Phone

(267) 421-8276

NPI assigned

Sep 29, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Other, 2024

Medicare assignment

May accept Medicare assignment

Group practices

Suburban Geriatric'S, Inc.Group PAC ID 4486551371, 102 clinicians

Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians

Violet Valley Long Term Care PCGroup PAC ID 9638683915, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Suburban Geriatrics II PC

  • Internal Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1073273363
  Medicare reassignment Care Compare group NPD
• Suburban Geriatrics, Inc.

  • Geriatric Medicine (Internal Medicine) Physician
  • Plymouth Meeting, PA
  • NPI 1679594808
  Medicare reassignment Care Compare group NPD
• Violet Valley Long Term Care PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Plymouth Meeting, PA
  • NPI 1649164617
  Medicare reassignment Care Compare group NPD
• Suburban Geriatrics at Home PC

  • Internal Medicine Physician
  • Plymouth Meeting, PA
  • NPI 1568122844
  Medicare reassignment

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764288000000",
    "number": "1093688731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4162 APPLE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271620",
            "telephone_number": "267-421-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4162 APPLE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271620",
            "telephone_number": "267-421-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLEY",
        "first_name": "JACQUELINE",
        "middle_name": "ANNE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-11-28",
        "certification_date": "2025-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP031312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Reid, NP-C
• Emily Reidy
• Katheleen Reidy, PH D
• Douglas Reifler, MD
• Karla E Reiland, CRNP
• Claire Reilly-Shapiro, CRNP, RN
• Anne F Reilly, M.D.
• Brian Thomas Reilly, MD
• Colleen Reilly
• Curran Elizabeth Reilly, MD

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2025; 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.