NPIMap

Individual provider Active NPI

Michelle Reily, CRNP

  • Family Nurse Practitioner
  • Willow Grove, PA
National Provider Identifier
1710311378
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013125 Issued in PA
Practice address
3941 Commerce Ave
Willow Grove, PA 19090-1104
Phone
(215) 481-4000
Fax
(215) 481-6790
NPI assigned
Aug 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP013125 PA Primary

Addresses

Primary practice location

3941 Commerce Ave
Willow Grove, PA 19090-1104

Mailing address

2500 Maryland Rd Ste 400
Willow Grove, PA 19090-1225
Phone (215) 481-4143

Other names 1

  • Michelle Dooley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131127000506 PA Practitioner - Nurse Practitioner 2062648843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (215) 707-3008

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027
  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196
  • St Mary Medical Center Hospital, Langhorne, PA, CCN 390258

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Einstein Practice Plan Inc Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jan 1, 2021 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Jan 1, 2021 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Sep 21, 2013 Accepting new patients
Einstein Practice Plan, Inc CurrentSince Sep 21, 2013 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

5501 Old York Rd
Ste 3
Philadelphia, PA 19141
Phone (215) 456-7180

333 Cottman Ave
#Int
Philadelphia, PA 19111
Phone (215) 728-2844

9880 Bustleton Ave
Ste 208
Philadelphia, PA 19115
Phone (215) 667-0667

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

Organizations & group practices 7

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1377820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1710311378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARYLAND RD STE 400",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901225",
            "telephone_number": "215-481-4143",
            "fax_number": "215-481-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 COMMERCE AVE",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901104",
            "telephone_number": "215-481-4000",
            "fax_number": "215-481-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILY",
        "first_name": "MICHELLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-30",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "DOOLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.