Individual provider Active NPI

Philip Andrew Reilly, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1275686552
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00037543 Issued in WA
Practice address
8720 14TH Ave S
Seattle, WA 98108-4807
Phone
(206) 762-3730
Fax
(206) 764-0523
NPI assigned
Jan 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00037543 WA Primary

Addresses

Primary practice location

8720 14TH Ave S
Seattle, WA 98108-4807

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 1

IdentifierTypeStateIssuer
1006681MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20041022000130 WA Practitioner - Family Practice 9436110558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

14434 Ambaum Blvd SW
Suite 5
Burien, WA 98166-1438
Phone (206) 812-6140

8720 14TH Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00037543WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Oct 18, 2008 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Oct 18, 2008 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients
Sea Mar Community Health Centers Past Accepting new patients

Locations

4455 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 671-3225

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

1412 NE 88th St
Vancouver, WA 98665
Phone (360) 574-4074

Interoperability endpoints

  • Direct secure messaging: preilly449447@direct.multicare.org

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1275686552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8720 14TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084807",
            "telephone_number": "206-762-3730",
            "fax_number": "206-764-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "PHILIP",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00037543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006681",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.