NPIMap

Individual provider Active NPI

Kerry K Reilly, PA

  • Surgical Physician Assistant
  • Albany, NY
National Provider Identifier
1326303678
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
015825 Issued in NY
Practice address
315 S Manning Blvd
RM 1677
Albany, NY 12208-1789
Phone
(518) 525-1550
Fax
(518) 525-1722
NPI assigned
Jul 11, 2012
Last updated
Aug 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 015825 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
RM 1677
Albany, NY 12208-1789

Mailing address

315 S Manning Blvd
RM 1677
Albany, NY 12208-1789
Phone (518) 525-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120910000100 NY Practitioner - Physician Assistant 9830347210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glens Falls Hospital IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

100 Park St
Glens Falls, NY 12801-4413
Phone (518) 926-1000

79 N St
Granville Medical Center
Granville, NY 12832-1137
Phone (518) 642-0612

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.44
Promoting interoperability
97.95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015825NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince Dec 3, 2018 Accepting new patients
Glens Falls Hospital Inc. CurrentSince Oct 31, 2022 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Glens Falls Hospital Inc CurrentSince Oct 31, 2022 Accepting new patients
Albany Medical College Current Accepting new patients
Albany Medical College Current Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

315 S Manning Blvd
Rm 1677
Albany, NY 12208

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

7 Southwoods Blvd
Albany, NY 12211
Phone (518) 292-6060

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

79 North St
Granville, NY 12832
Phone (518) 642-0612

1769 Union St
Ste 2
Niskayuna, NY 12309
Phone (518) 382-1151

Interoperability endpoints

  • Direct secure messaging: kreilly101645@albanymed.direct-ci.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1326303678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "RM 1677",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081789",
            "telephone_number": "518-525-1550",
            "fax_number": "518-525-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "RM 1677",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081789",
            "telephone_number": "518-525-1550",
            "fax_number": "518-525-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "KERRY",
        "middle_name": "K",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "015825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.