Maryellen O'Reilly, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G63194 Issued in CA

Practice address

60 Discovery
Irvine, CA 92618-3105

Phone

(949) 586-9904

Fax

(949) 586-7816

NPI assigned

May 8, 2008

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 names 1

• Dr. Maryellen Debonis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1780851808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 DISCOVERY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183105",
            "telephone_number": "949-586-9904",
            "fax_number": "949-586-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 DISCOVERY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183105",
            "telephone_number": "949-586-9904",
            "fax_number": "949-586-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'REILLY",
        "first_name": "MARYELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G63194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYELLEN",
            "last_name": "DEBONIS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.