MICHAEL THOMAS O'REILLY
NPI 1982970968
Pediatrics in New Rochelle, NY
NPI Status: Active since March 23, 2012
Contact Information
171 HUGUENOT ST
NEW ROCHELLE, NY
ZIP 10801
Phone: (914) 607-4720
Fax: (914) 607-4721
- Individual
- Male
- Pediatrics
- Accepts Insurance
- PECOS Enrolled
About MICHAEL O'REILLY
This page provides the complete NPI Profile along with additional information for Michael O'reilly, a pediatrician established in New Rochelle, New York with a medical specialization in Pediatrics. The healthcare provider is registered in the NPI registry with number 1982970968 assigned on March 2012. The practitioner's primary taxonomy code is 208000000X with license number 309724 (NY). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1982970968
- Provider Name
- MICHAEL THOMAS O'REILLY
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 171 HUGUENOT ST NEW ROCHELLE, NY 10801
- Location Phone
- (914) 607-4720
- Location Fax
- (914) 607-4721
- Mailing Address
- 800 WESTCHESTER AVE STE N715 RYE BROOK, NY 10573
- Mailing Phone
- (914) 607-5730
- Mailing Fax
- (914) 607-4721
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-23-2012
- Last Update Date
- 05-24-2023
- Code Navigator
A pediatrician like Michael O'reilly is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 309724
- License State
- NY
- Taxonomy Description
- A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 61490-20 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michael O'reilly is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 10801 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $105.06
- Minimum New Patient Price $67.4
- Maximum New Patient Price $203.53
- Average New Patient Copayment $26.26
- Minimum New Patient Copayment $16.85
- Maximum New Patient Copayment $50.88
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $117.62
- Minimum Established Patient Price $21.66
- Maximum Established Patient Price $164.45
- Average Established Patient Copayment $29.4
- Minimum Established Patient Copayment $5.41
- Maximum Established Patient Copayment $41.11
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1982970968, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
NEW ROCHELLE, NY 10801
NEW ROCHELLE, NY 10801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982970968, enumerated as an "individual" on March 23, 2012.
The provider is located at 171 HUGUENOT ST NEW ROCHELLE, NY 10801 and the phone number is (914) 607-4720.
Pediatrics with taxonomy code 208000000X.
The provider might be accepting Accepts: CareSource (Common Ground Healthcare). Please consult your insurance carrier or call the provider to verify.
