Sean M Reilly, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

AMD183 Issued in HI

Practice address

75-170 Hualalai Rd
Ste C-110
Kailua Kona, HI 96740-1741

Phone

(808) 329-9211

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Alii Community Care, Inc

  • General Practice Physician
  • Kailua Kona, HI
  • NPI 1114127859
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497785596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-170 HUALALAI RD",
            "address_2": "STE C-110",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401741",
            "telephone_number": "808-329-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-170 HUALALAI RD",
            "address_2": "STE C-110",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401741",
            "telephone_number": "808-329-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SEAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AMD183",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas C Rayson, M.D.
• Reach Air Medical Services LLC
• Serena A. Reed, MD
• Jessica Ramos Regpala
• Rehabilitation Hospital of the Pacific
• Reina Acacio LMFT
• Resilient Connections Counseling LLC
• Retina Institute of Hawaii LLC
• Stephen Anthony Reynolds, PSYD
• Mark S. Rhee, MD

• Medical Physician Assistant in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Medical Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.