Shane Thomas Reilly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

55 Fogg Rd
South Weymouth, MA 02190-2455

Phone

(781) 624-8000

NPI assigned

Jan 5, 2018

Sex

Male

Sole proprietor

No

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

Enrolled in MA

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 1

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as group

Quality

88.12

Promoting interoperability

71

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Enrolled

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.

• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment
• South Shore Medical Center, Inc.

  • Internal Medicine Physician
  • Norwell, MA
  • NPI 1669411856
  Medicare reassignment

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1972010429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902455",
            "telephone_number": "781-624-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FOGG RD",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021902455",
            "telephone_number": "781-624-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "485 Granite St",
            "address_purpose": "LOCATION",
            "city": "Braintree",
            "state": "MA",
            "postal_code": "02184",
            "country_code": "US",
            "telephone_number": "781-848-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Providence Hwy",
            "address_purpose": "LOCATION",
            "city": "East Walpole",
            "state": "MA",
            "postal_code": "020321512",
            "country_code": "US",
            "telephone_number": "781-255-0500",
            "fax_number": "781-255-0400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 Longwater Dr",
            "address_purpose": "LOCATION",
            "city": "Norwell",
            "state": "MA",
            "postal_code": "020611683",
            "country_code": "US",
            "telephone_number": "781-878-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANE",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-05",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Afreen Rahman, M.ED
• Rebecca Ramirez-McKinely, MS, LAT, ATC, CSCS,
• Carissa C Rand, PHYSICIAN ASSISTANT
• Denise C. Reardon, NP
• Pranitha Reddy, M.D.
• Ching Chan Reisig, M.D.
• Mary Clare Rhodes, RN
• Kimberly A Riley, LICSW
• Michael James Riley, RN
• Emily Christine Roblee, MD

• Physician Assistant in South Weymouth, MA
• Providers in South Weymouth, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.