Individual provider Active NPI

Michael T Reilly, M.D.

  • Adult Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1770534240
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME32973 Issued in FL
Practice address
1201 5TH Ave North
Suite 401
St Petersburg, FL 33705
Phone
(727) 821-1132
Fax
(727) 822-2977
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME32973 FL Primary

Addresses

Primary practice location

1201 5TH Ave North
Suite 401
St Petersburg, FL 33705

Mailing address

1201 5TH Ave N
Suite 401
St Petersburg, FL 33705
Phone (727) 821-1132

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000256 FL Practitioner - Family Practice 8820980071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1201 5TH Ave N
Suite 401
St Petersburg, FL 33705-1425

1201 5TH N Ave
Suite 401
Saint Petersburg, FL 33705-1425
Phone (813) 821-1132

Hospital & facility affiliations

  • Baycare Home Care Inc Home health agency, Largo, FL, CCN 107212
  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075
  • St Anthonys Hospital Hospital, Saint Petersburg, FL, CCN 100067
  • Morton Plant Hospital Hospital, Clearwater, FL, CCN 100127

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Michael T Reilly MD PA CurrentSince Aug 1, 1978 Accepting new patients
Michael T Reilly MD PA PastSince Jan 1, 1990 Accepting new patients

Locations

1201 5th Ave N
Ste 401
St Petersburg, FL 33705
Phone (727) 821-1132

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAEHBA/Endpoint/BAEHBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/BAEHBA

Organizations & group practices 2

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 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1770534240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33705",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE NORTH",
            "address_2": "SUITE 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33705",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME32973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.