Diane G Reilly, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7734 Issued in MA

Practice address

12 Alfred St
Suite 200
Woburn, MA 01801-1972

Phone

(781) 646-0500

Fax

(781) 646-7130

NPI assigned

Mar 13, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Child and Family Psychological Services, PLLC

  • Psychologist
  • Norwood, MA
  • NPI 1912987181

  Clinical

  NPD (past)
• Psychological Care Associates, P.C.

  • Clinical Psychologist
  • Woburn, MA
  • NPI 1194770479
  NPD (past)

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1821363615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST",
            "address_2": "SUITE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011972",
            "telephone_number": "781-646-0500",
            "fax_number": "781-646-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ALFRED ST",
            "address_2": "SUITE 200",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011972",
            "telephone_number": "781-646-0500",
            "fax_number": "781-646-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "DIANE",
        "middle_name": "G",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Reed
• Ashley Shalea Reeves, MSW
• Michelle Reggio, PTA
• Scott Reid
• Caroline Reilley, PNP
• Michelle Reitano
• Reliable Health Alliance LLC
• Reliable Respiratory Inc
• Allison Kate Renaud
• Juliette Renzullo, N.P.

• Clinical Psychologist in Woburn, MA
• Providers in Woburn, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.