Active NPI
Daniel L Reilly, DO
- Psychiatry Physician
- Monroe, WI
National Provider Identifier
1811061286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 36799
- Practice address
- 515 22ND Ave
Monroe, WI 53566-1569 - Phone
- (608) 324-1000
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 36799 | WI | Primary |
| Psychiatry Physician | 2084P0800X | IL |
Addresses
Primary practice location
515 22ND Ave
Monroe, WI 53566-1569
Mailing address
515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-1000
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90002361 | Other | WEA INS | |
| 1004959 | Other | PHYSICIANS PLUS | |
| 30066900 | Other | HIRSP | |
| 39080850934 | Other | UNITY | |
| 11060 | Other | DEAN HEALTH PLAN | |
| 30066900 | Medicaid | WI | |
| L55671 | Other | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-092165 | IL | MD | Psychiatry Physician |
| 36799 | WI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811061286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REILLY",
"first_name": "DANIEL",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "36799",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEA INS",
"identifier": "90002361",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS",
"identifier": "1004959",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIRSP",
"identifier": "30066900",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY",
"identifier": "39080850934",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "11060",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30066900",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "L55671",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.