Active NPI
Terry Ellen O'Reilly, M.D.
- Family Medicine Physician
- Mesa, AZ
National Provider Identifier
1356539787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 37635
- Practice address
- 6550 E Broadway Rd Ste 103
Mesa, AZ 85206-1734 - Phone
- (480) 924-0425
- Fax
- (480) 924-0495
- NPI assigned
- Oct 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 37635 | AZ | Primary |
Addresses
Primary practice location
6550 E Broadway Rd Ste 103
Mesa, AZ 85206-1734
Mailing address
6550 E Broadway Rd Ste 103
Mesa, AZ 85206-1734
Phone (480) 924-0425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 14, 2020 through Nov 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37635 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1356539787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6550 E BROADWAY RD STE 103",
"city": "MESA",
"state": "AZ",
"postal_code": "852061734",
"telephone_number": "480-924-0425",
"fax_number": "480-924-0495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6550 E BROADWAY RD STE 103",
"city": "MESA",
"state": "AZ",
"postal_code": "852061734",
"telephone_number": "480-924-0425",
"fax_number": "480-924-0495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'REILLY",
"first_name": "TERRY",
"middle_name": "ELLEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-10",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "37635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.