NPIMap

Organization Active NPI

Michael T Reilly MD PA

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1144612623
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME32973 Issued in FL
Legal business name
MICHAEL T REILLY MD PA
Practice address
1201 5TH Ave N
St Petersburg, FL 33705-1400
Phone
(727) 821-1132
Fax
(727) 822-2977
NPI assigned
Feb 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Authorized official

Name
Dr. Michael Timothy Reilly, MDNPI 1770534240
Title
President
Phone
(727) 821-1132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME32973 FL Primary

Addresses

Primary practice location

1201 5TH Ave N
St Petersburg, FL 33705-1400

Mailing address

1201 5TH Ave N
St Petersburg, FL 33705-1400
Phone (727) 821-1132

National Provider Directory

National Provider Directory
Tax ID family
Michael T Reilly MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1201 5th Ave N
St Petersburg, FL 33705
Phone (727) 821-0017

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAEHBA

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1144612623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T REILLY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-821-1132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME32973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.