Michael T Reilly MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME32973 Issued in FL

Legal business name

MICHAEL T REILLY MD PA

Practice address

1201 5TH Ave N
Suite 401
St Petersburg, FL 33705-1400

Phone

(727) 821-1132

Fax

(727) 822-2977

NPI assigned

Oct 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael T Reilly, MDNPI 1770534240

Title

President

Phone

(727) 821-1132

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Michael T Reilly MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Michael T Reilly MD PA

  • Family Medicine Physician
  • St Petersburg, FL
  • NPI 1144612623
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael T Reilly, M.D.

  • Adult Medicine Physician
  • St Petersburg, FL
  • NPI 1770534240
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353369600000",
    "number": "1992058358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE N",
            "address_2": "SUITE 401",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051400",
            "telephone_number": "727-821-1132",
            "fax_number": "727-822-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T REILLY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2012-11-20",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-821-1132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME32973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045627600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael E Whalen LMHC
• Michael J Smith MD PA
• Michael K Garner DC PLLC
• Michael M Newan MD PA
• Michael T Reilly MD PA
• Carolyn Michael, M.S
• George Michael, DO
• Jenny E Michael, M.D.
• Mariel Faith Michaels, MD
• Sharon Renee Michaels, LCSW,CAP

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.