Active NPI
Colin Russell O'Reilly, D.O.
- Pediatric Critical Care Medicine Physician
- New Brunswick, NJ
National Provider Identifier
1356671887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- 25MB08636600
- Practice address
- 200 Somerset St
New Brunswick, NJ 08901-1942 - Phone
- (732) 258-7000
- NPI assigned
- Jan 6, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | 25MB08636600 | NJ | Primary |
Addresses
Primary practice location
200 Somerset St
New Brunswick, NJ 08901-1942
Mailing address
200 Somerset St
New Brunswick, NJ 08901-1942
Phone (732) 258-7000
Other practice location 1
100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-7550
Other practice location 2
100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-7550
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0232050 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB08636600 | NJ | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children' Specialized Hospital | Current | Accepting new patients | |
| Children'S Specialized Hospital | Current | Accepting new patients |
Locations
150 New Providence Rd
Mountainside, NJ 07092
200 Somerset St
New Brunswick, NJ 08901
Phone (732) 258-7000
Organizations & group practices 2
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.
-
- Children's Rehabilitation Hospital
- New Brunswick, NJ
- NPI 1396886297
-
- Medically Fragile Infants and Children Day Care
- Mountainside, NJ
- NPI 1578604476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1356671887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 SOMERSET ST",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089011942",
"telephone_number": "732-258-7000",
"fax_number": "908-389-5675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 SOMERSET ST",
"city": "NEW BRUNSWICK",
"state": "NJ",
"postal_code": "089011942",
"telephone_number": "732-258-7000"
}
],
"practiceLocations": [
{
"address_1": "100 Madison Ave",
"address_purpose": "LOCATION",
"city": "Morristown",
"state": "NJ",
"postal_code": "079606136",
"country_code": "US",
"telephone_number": "973-971-7550",
"fax_number": "973-290-7364",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Madison Ave",
"address_purpose": "LOCATION",
"city": "Morristown",
"state": "NJ",
"postal_code": "079606136",
"country_code": "US",
"telephone_number": "973-971-7550",
"fax_number": "973-290-7364",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'REILLY",
"first_name": "COLIN",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-06",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "NJ",
"license": "25MB08636600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0232050",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.