Theresa Korneluk Reilly, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

020803E Issued in PA

Practice address

2418 E Allegheny Ave
Philadelphia, PA 19134-4403

Phone

(215) 634-6660

Fax

(215) 739-6777

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Jefferson Medical College of Thomas Jefferson University, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cottman Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Philadelphia, PA
  • NPI 1629153770
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1700828472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2418 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344403",
            "telephone_number": "215-634-6660",
            "fax_number": "215-739-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344403",
            "telephone_number": "215-634-6660",
            "fax_number": "215-739-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "THERESA",
        "middle_name": "KORNELUK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "020803E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0842013",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick M Reilly, MD
• Paul Reilly, MD
• Sean Patrick Reilly
• Sheila Reilly, RDH
• Taylor Marie Reilly
• Timothy Reilly, PT, DPT
• Jack Christopher Reimer
• Kathleen Rein
• Vanessa L Rein, MD
• Elizabeth Mae Reiner, CRNP

• Ophthalmology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ophthalmology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.