Individual provider Active NPI

Theresa Ann Reilly, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Brick, NJ
National Provider Identifier
1902316565
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00900500 Issued in NJ
Practice address
39 Toronto Dr
Brick, NJ 08723-7531
Phone
(732) 236-8361
NPI assigned
Oct 9, 2017
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 431187 NY
Gerontology Nurse Practitioner 363LG0600X 26NJ00900500 NJ Primary

Addresses

Primary practice location

39 Toronto Dr
Brick, NJ 08723-7531

Mailing address

1945 Route 33
Neptune, NJ 07753
Phone (732) 776-4292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190329001296 NY Practitioner - Nurse Practitioner 4587904560 Reassigns benefits to 1 organization
I20191030001878 NJ Practitioner - Nurse Practitioner 4587904560 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
431187NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Jul 1, 2024 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Jul 1, 2024 Accepting new patients
New York University CurrentSince Feb 17, 2019 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
New York University CurrentSince Feb 17, 2019 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Oct 20, 2022 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD
  • Direct secure messaging: theresa.reilly@direct.hackensackmeridian.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1902316565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 ROUTE 33",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-776-4292",
            "fax_number": "732-776-4213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 TORONTO DR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237531",
            "telephone_number": "732-236-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431187",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00900500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.