NPIMap

Individual provider Active NPI

John P Reilly, M.D.

  • Surgery Physician
  • Salisbury, MD
National Provider Identifier
1285628693
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0063980 Issued in MD
Practice address
145 E Carroll St
Salisbury, MD 21801-5454
Phone
(410) 548-2600
Fax
(410) 548-2607
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 22364 NE
Surgery Physician 208600000X D0063980 MD Primary

Addresses

Primary practice location

145 E Carroll St
Salisbury, MD 21801-5454

Mailing address

145 E Carroll St
Salisbury, MD 21801-5454
Phone (410) 912-6172

Other practice location 1

804 Snow Hill Rd
Salisbury, MD 21804-1938
Phone (410) 543-7599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000390 MD Practitioner - General Surgery 9436196292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 912-4976

Hospital & facility affiliations

  • Tidalhealth Home Care Home health agency, Salisbury, MD, CCN 217079
  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
  • Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy47
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux19
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0063980MDMDSurgery Physician
22364NEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Specialty Care, LLC CurrentSince Dec 1, 2021 Accepting new patients
Peninsula Surgical Group, P.a. Past Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients
Creighton University Past Accepting new patients
Creighton University Surgery Past Accepting new patients

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

804 Snow Hill Rd
Salisbury, MD 21804
Phone (410) 543-7599

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1285628693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015454",
            "telephone_number": "410-912-6172",
            "fax_number": "410-912-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015454",
            "telephone_number": "410-548-2600",
            "fax_number": "410-548-2607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Snow Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218041938",
            "country_code": "US",
            "telephone_number": "410-543-7599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "22364",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0063980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.