Mary T Reilly Pelini, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.004173RX Issued in OH

Practice address

1 Perkins SQ
Akron, OH 44308-1063

Phone

(330) 543-8580

Fax

(330) 543-3220

NPI assigned

Dec 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Therese Reilly Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpelini106199@direct.chmca.org

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.

• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment NPD
• Akron Children'S Hospital

  • Children's Hospital
  • Akron, OH
  • NPI 1942465752
  NPD
• Crystal Clinic Orthopaedic Center LLC

  • Special Hospital
  • Akron, OH
  • NPI 1669669917
  NPD
• Crystal Clinic Orthopaedic Center LLC

  • Special Hospital
  • Akron, OH
  • NPI 1811651508

  Physician Assistant

  NPD
• Children'S Hospital Medical Center of Akron

  • Pediatrics Physician
  • Akron, OH
  • NPI 1841328853
  NPD (past)

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1205233418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8580",
            "fax_number": "330-543-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8580",
            "fax_number": "330-543-3220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3975 Embassy Pkwy",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443338320",
            "country_code": "US",
            "telephone_number": "330-668-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELINI",
        "first_name": "MARY",
        "middle_name": "T REILLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.004173",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.004173RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "REILLY",
            "middle_name": "THERESE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pediatrics of Akron, Inc.
• Christina J. Pegues, LCDCIII
• Leia Peison
• Bernadette Marie Pejic, CPNP
• Ashley Marie Pekarski, RN
• Michael A Pelini, MD
• Bennett Jacob Pelton, DO
• Eugenio A Peluso, PHD
• Michael Anthony Pena, M.D
• Seth Michael Pender

• Physician Assistant in Akron, OH
• Providers in Akron, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.