NPIMap

Individual provider Active NPI

Shannon M Reilly, PA-C

  • Physician Assistant
  • Cincinnati, OH
National Provider Identifier
1982118378
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007901RX Issued in OH
Practice address
3825 Edwards Rd Ste 300
Cincinnati, OH 45209-1288
Phone
(513) 221-1100
Fax
(513) 684-4501
NPI assigned
Nov 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07438 NC
Physician Assistant 363A00000X 50.007901RX OH Primary

Addresses

Primary practice location

3825 Edwards Rd Ste 300
Cincinnati, OH 45209-1288

Mailing address

PO Box 643398
Cincinnati, OH 45264-3398
Phone (513) 221-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230217001776 OH Practitioner - Physician Assistant 6507125515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayfield Clinic IncGroup PAC ID 9133013006, 74 clinicians
Oxford Physical Therapy and RehabilitationGroup PAC ID 0244232874, 432 clinicians

Practice addresses (Care Compare)

10500 Montgomery Rd
Cincinnati, OH 45242-4402
Phone (513) 221-1100

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 221-1100

7567 Central Parke Blvd
Mason, OH 45040-6852

Hospital & facility affiliations

  • Christ Hospital Hospital, Cincinnati, OH, CCN 360163
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • The Jewish Hospital-Mercy Health Hospital, Cincinnati, OH, CCN 360016
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50.007901RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfield Clinic Inc CurrentSince Jan 9, 2023 Accepting new patients
Mayfield Clinic Inc Physician Assistant CurrentSince Jan 9, 2023 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3825 Edwards Rd
Ste 300
Cincinnati, OH 45209

7661 Beechmont Ave
Cincinnati, OH 45255
Phone (513) 233-4900

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

Interoperability endpoints

  • Direct secure messaging: shannon.reilly@mayfield.eclinicaldirectplus.com
  • Direct secure messaging: sreilly@1241.direct.myezyaccess.com

Organizations & group practices 4

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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1982118378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643398",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452643398",
            "telephone_number": "513-221-1100",
            "fax_number": "513-684-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EDWARDS RD STE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091288",
            "telephone_number": "513-221-1100",
            "fax_number": "513-684-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-22",
        "last_updated": "2023-01-10",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07438",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007901RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.