Individual provider Active NPI

Haley L O'Reilly, PA

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1154787752
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10318 Issued in GA
Practice address
1365 Clifton Rd NE
Atlanta, GA 30322-2134
Phone
(404) 778-1900
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109164 FL
Physician Assistant 363A00000X 10318 GA Primary

Addresses

Primary practice location

1365 Clifton Rd NE
Atlanta, GA 30322-2134

Mailing address

1365 Clifton Rd NE
Atlanta, GA 30322-1841
Phone (404) 778-1900

Other identifiers 2

IdentifierTypeStateIssuer
016570700MedicaidFL
PA9109164OtherFLMEDICAL LICENSE

Other names 1

  • Ms. Haley L Tolvstad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160222000665 FL Practitioner - Physician Assistant 4183929672 Reassigns benefits to 1 organization
I20210803000882 GA Practitioner - Physician Assistant 4183929672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109164FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 15, 2017 Accepting new patients
The Emory Clinic Inc CurrentSince Jul 5, 2021 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9964 University Blvd
Orlando, FL 32817
Phone (407) 261-2900

1400 S Orange Ave
Orlando, FL 32806
Phone (321) 841-1893

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: horeilly30974@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1154787752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221841",
            "telephone_number": "404-778-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303222134",
            "telephone_number": "404-778-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'REILLY",
        "first_name": "HALEY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2021-07-07",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109164",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016570700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9109164",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "TOLVSTAD",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.