Paul K Reilley Sr., PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03246 Issued in TX

Practice address

17270 Red Oak Dr
Suite 200
Houston, TX 77090-2632

Phone

(281) 440-6960

Fax

(281) 440-6205

NPI assigned

May 4, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Baylor College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aic Urgent Care. PLLCGroup PAC ID 5890956650, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: paul.reilley@fmasr.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aic Urgent Care. PLLC

  • Urgent Care Clinic/Center
  • La Marque, TX
  • NPI 1962788125
  Medicare reassignment Care Compare group
• Aic Primary Care, PLLC

  dba Affinity Immediate Care, LLC

  • Primary Care Clinic/Center
  • La Marque, TX
  • NPI 1326324567
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780632976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4356",
            "address_2": "DEPT. 665",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104356",
            "telephone_number": "281-440-6960",
            "fax_number": "281-440-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17270 RED OAK DR",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770902632",
            "telephone_number": "281-440-6960",
            "fax_number": "281-440-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLEY",
        "first_name": "PAUL",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03246",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA03246",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "K01311851",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSE",
            "identifier": "PA03246",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Lee Reid, OD
• Sarah Ann Reid, LCSW
• Jessenia Reider
• Mary Genevieve (Suzy) Reierson, LPC. LCDC
• Rubi Reiger, PNP
• Harley Reilly, RBT
• Joseph Arthur Reilly Jr., DC
• Kristen Taylor Reilly
• Sean Patrick Reilly, PHARMD
• Sharron Reilly, OT

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.