Individual provider Active NPI

Megan M. Reilly, M.D.

  • Pediatrics Physician
  • Plymouth, MN
National Provider Identifier
1124095427
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
44068 Issued in MN
Practice address
2855 Campus Dr
#350
Plymouth, MN 55441-2649
Phone
(763) 520-1200
Fax
(763) 520-1201
NPI assigned
Mar 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 44068 MN Primary

Addresses

Primary practice location

2855 Campus Dr
#350
Plymouth, MN 55441-2649

Mailing address

2855 Campus Dr
#350
Plymouth, MN 55441-2649
Phone (763) 520-1200

Other names 1

  • Dr. Megan R. Jennings Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150331000934 MN Practitioner - Pediatric Medicine 2466779574 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44068MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Clinic Network Current Accepting new patients
Children'S Clinic Network CurrentSince Jan 14, 2015 Accepting new patients
Children'S Clinic Network CurrentSince Jan 14, 2015 Accepting new patients
Maple Grove Hospital Corporation Past Accepting new patients
Metropolitan Pediatric Specialists, P.a. Past Accepting new patients

Locations

12720 Bass Lake Rd
Maple Grove, MN 55369
Phone (763) 278-0804

6060 Clearwater Dr
Ste 210
Minnetonka, MN 55343
Phone (763) 520-1200

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

1547 Livingston Ave
West St Paul, MN 55118
Phone (651) 451-8050

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1124095427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR",
            "address_2": "#350",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412649",
            "telephone_number": "763-520-1200",
            "fax_number": "763-520-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR",
            "address_2": "#350",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412649",
            "telephone_number": "763-520-1200",
            "fax_number": "763-520-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MEGAN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-06",
        "last_updated": "2023-08-09",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "44068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "JENNINGS",
            "middle_name": "R.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.