NPIMap

Individual provider Active NPI

Jenna L Reilly, PA-C

  • Physician Assistant
  • Scranton, PA
National Provider Identifier
1962290346
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA067212 Issued in PA
Practice address
1800 Mulberry St
Scranton, PA 18510-2369
Phone
(570) 703-7355
Fax
(570) 703-7354
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA067212 PA Primary

Addresses

Primary practice location

1800 Mulberry St
Scranton, PA 18510-2369

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 703-7355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251210000647 PA Practitioner - Physician Assistant 4385138122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

1800 Mulberry St
Scranton, PA 18510-2369
Phone (570) 969-7355

Hospital & facility affiliations

  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001
  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA067212PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 17, 2025 Accepting new patients
Geisinger Clinic Physician Assistant Current Accepting new patients
Geisinger Clinic CurrentSince Nov 17, 2025 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

Organizations & group practices 3

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.

Hospital & facility affiliations 30

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1962290346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-703-7355",
            "fax_number": "570-703-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MULBERRY ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185102369",
            "telephone_number": "570-703-7355",
            "fax_number": "570-703-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "JENNA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA067212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.