Individual provider Active NPI

Michael Patrick Reilly, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Doylestown, PA
National Provider Identifier
1285835785
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SL003169L Issued in PA
Practice address
4029 N Mallard LN
Doylestown, PA 18901-1233
Phone
(267) 716-8463
Fax
(215) 230-4580
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL003169L PA Primary

Addresses

Primary practice location

4029 N Mallard LN
Doylestown, PA 18901-1233

Mailing address

4029 N Mallard LN
Doylestown, PA 18901-1233
Phone (267) 716-8463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SL003169LPAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1285835785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4029 N MALLARD LN",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189011233",
            "telephone_number": "267-716-8463",
            "fax_number": "215-230-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 N MALLARD LN",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189011233",
            "telephone_number": "267-716-8463",
            "fax_number": "215-230-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL003169L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.