Active NPI
Maggie E Reilly, PA
- Physician Assistant
- Rochester, NY
National Provider Identifier
1629084298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 010248
- Practice address
- 117 Lomb Memorial Dr
Rochester, NY 14623-5608 - Phone
- (585) 475-2255
- Fax
- (585) 475-7788
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 010248 | NY | Primary |
Addresses
Primary practice location
117 Lomb Memorial Dr
Rochester, NY 14623-5608
Mailing address
117 Lomb Memorial Dr
Rochester, NY 14623-5608
Phone (585) 475-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02618220 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mershc@rit.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010248 | NY | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard S Aguirre | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lakeville Family Medicine
- Family Medicine Physician
- Lakeville, NY
- NPI 1710992151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1629084298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 LOMB MEMORIAL DR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146235608",
"telephone_number": "585-475-2255",
"fax_number": "585-475-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 LOMB MEMORIAL DR",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146235608",
"telephone_number": "585-475-2255",
"fax_number": "585-475-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "MAGGIE",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "010248",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02618220",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mershc@rit.edu",
"affiliation": "N",
"address_1": "117 Lomb Memorial Dr",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146235608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.