Amanda Jane Reilly, APRN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

RN2265481 Issued in MA

Practice address

57 Sachemus TRL
Brewster, MA 02631-2080

Phone

(413) 210-5352

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Connecticut Children's Specialty Group, Inc.

  • Ophthalmology Physician
  • Glastonbury, CT
  • NPI 1568056984
  NPD
• Connecticut Children's Specialty Group, Inc.

  • Pediatrics Physician
  • Hartford, CT
  • NPI 1669448882
  NPD

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1417231895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 SACHEMUS TRL",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312080",
            "telephone_number": "413-210-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 SACHEMUS TRL",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312080",
            "telephone_number": "413-210-5352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MA",
            "license": "RN2265481",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "APRN #004703",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN2265481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417231895",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pleasant Bay of Brewster Rehab Center LLC
• Polished,LLC
• Monda Sue Prior, MSW
• Melissa Quast, R.N.
• Raymond G. Magauran, M.D., P.C.
• Katherine Romagnoli
• Nancy B. Samotis, L.C.S.W.
• Wilderness Sarchild, M.A.
• Colleen E Sari, MD
• Edward J Sayer, PSY.D.

• Adult Psychiatric/Mental Health Registered Nurse in Brewster, MA
• Providers in Brewster, MA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.

Verify at the official NPI Registry.