Individual provider Active NPI

Michael D Reilly, DNP, ARNP, NP-C

  • Family Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1528045168
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3185122 Issued in FL
Practice address
2500 Citrus Blvd
Leesburg, FL 34748-3063
Phone
(352) 347-5225
Fax
(352) 347-1073
NPI assigned
Dec 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3185122 FL
Family Nurse Practitioner 363LF0000X 3185122 FL Primary

Addresses

Primary practice location

2500 Citrus Blvd
Leesburg, FL 34748-3063

Mailing address

10762 SE US Highway 441
Belleview, FL 34420-3805
Phone (352) 347-5225

Other practice location 1

10762 SE US Highway 441
Belleview, FL 34420-3805
Phone (352) 347-5225

Other identifiers 1

IdentifierTypeStateIssuer
000144500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080730000608 FL Practitioner - Nurse Practitioner 5698849289 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3185122FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Emergency Physician Services Inc Nurse Practitioner CurrentSince Aug 1, 2014 Accepting new patients
Express Care of Belleview, LLC CurrentSince May 29, 2020 Accepting new patients
Fakhoury Medical & Chiropractic Center PLLC CurrentSince Jun 30, 2024 Accepting new patients
Express Care of Belleview, LLC CurrentSince May 29, 2020 Accepting new patients
Sheridan Emergency Physician Services Inc Nurse Practitioner CurrentSince Aug 1, 2014 Accepting new patients
Institute of Cardiovascular Medicine LLC Past Accepting new patients
Institute of Cardiovascular Excellence PLLC Past Accepting new patients
Ocala Physician Associates PA PastSince Oct 14, 2018 Accepting new patients

Locations

10762 SE US Highway 441
Belleview, FL 34420
Phone (352) 346-5225

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

2500 Citrus Blvd
Leesburg, FL 34748
Phone (352) 315-3804

1009 SW 17th St
Ocala, FL 34471
Phone (352) 351-3413

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61486

Organizations & group practices 8

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": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1528045168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10762 SE US HIGHWAY 441",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203805",
            "telephone_number": "352-347-5225",
            "fax_number": "352-347-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 CITRUS BLVD",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483063",
            "telephone_number": "352-347-5225",
            "fax_number": "352-347-1073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10762 SE US Highway 441",
            "address_purpose": "LOCATION",
            "city": "Belleview",
            "state": "FL",
            "postal_code": "344203805",
            "country_code": "US",
            "telephone_number": "352-347-5225",
            "fax_number": "352-347-1073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DNP, ARNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-26",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "3185122",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3185122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000144500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.