Individual provider Active NPI

Michael O'Reilly, M.D.

  • Obstetrics & Gynecology Physician
  • Shelton, CT
National Provider Identifier
1891723995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
031581 Issued in CT
Practice address
4 Corporate Dr
Suite # 484
Shelton, CT 06484-6211
Phone
(203) 944-9898
Fax
(203) 944-9899
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 031581 CT Primary

Addresses

Primary practice location

4 Corporate Dr
Suite # 484
Shelton, CT 06484-6211

Mailing address

4 Corporate Dr
Suite # 484
Shelton, CT 06484-6211
Phone (203) 944-9898

Other identifiers 1

IdentifierTypeStateIssuer
001315812MedicaidCT

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 Medicine

State licenses

LicenseStateTypeSpecialty
031581CTMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891723995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "address_2": "SUITE # 484",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846211",
            "telephone_number": "203-944-9898",
            "fax_number": "203-944-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CORPORATE DR",
            "address_2": "SUITE # 484",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064846211",
            "telephone_number": "203-944-9898",
            "fax_number": "203-944-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'REILLY",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "031581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001315812",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

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.

Verify at the official NPI Registry.