Individual provider Active NPI

Jeannette C.a Reilly, DPM

  • Podiatrist
  • Galloway, NJ
National Provider Identifier
1376635458
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
25MD00213100 Issued in NJ
Practice address
76 West Jimmie Leeds Rd
Suite 203
Galloway, NJ 08205-9417
Phone
(609) 404-1300
Fax
(609) 404-1929
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 25MD00213100 NJ Primary

Addresses

Primary practice location

76 West Jimmie Leeds Rd
Suite 203
Galloway, NJ 08205-9417

Mailing address

76 W Jimmie Leeds Rd
Suite 203
Galloway, NJ 08205-9411
Phone (609) 404-1300

Other identifiers 1

IdentifierTypeStateIssuer
5524601MedicaidNJ

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100916000379 NJ Practitioner - Podiatry 6901921741 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curalta Medical LLCGroup PAC ID 0749670453, 69 clinicians

Practice addresses (Care Compare)

504 Hamburg Tpke
Suite 101
Wayne, NJ 07470-2011
Phone (973) 956-8600

76 W Jimmie Leeds Rd
Suite 203
Galloway, NJ 08205-9417
Phone (609) 404-1300

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
83.84
Promoting interoperability
87
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue831
Removal or shaving of skin growth62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Foot and Ankle Care PC Podiatrist CurrentSince May 24, 1995 Accepting new patients
Curalta Medical LLC Podiatrist CurrentSince Oct 22, 2024 Accepting new patients
Curalta Medical LLC Podiatrist CurrentSince Oct 22, 2024 Accepting new patients

Locations

76 W Jimmie Leeds Rd
Ste 203
Galloway, NJ 08205
Phone (609) 404-1300

504 Hamburg Tpke
Ste 101
Wayne, NJ 07470
Phone (973) 956-8600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4399/brand/8/csg/41/fhir/r4
  • Direct secure messaging: jeannette.reilly@atlanticfootandankle.chartmakerdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1376635458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 W JIMMIE LEEDS RD",
            "address_2": "SUITE 203",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059411",
            "telephone_number": "609-404-1300",
            "fax_number": "609-404-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 WEST JIMMIE LEEDS RD",
            "address_2": "SUITE 203",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059417",
            "telephone_number": "609-404-1300",
            "fax_number": "609-404-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JEANNETTE",
        "middle_name": "C.A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00213100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5524601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galloway, NJ

Sources for this page

Verify at the official NPI Registry.