Kathleen Reilly, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Providence, Rhode Island. She graduated from healthcare school in 2023 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lifespan Physician Group Inc and her current practice location is
194 Waterman St, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at
(401) 633-2929.
Kathleen Reilly is licensed to practice in Rhode Island (license number APRN03630) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417659962.
Healthcare Provider's Profile
| Full Name | Kathleen Reilly |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 194 Waterman St, Providence, Rhode Island |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Kathleen Reilly graduated from medical school in 2023
NPI Data:
- NPI Number: 1417659962
- Provider Enumeration Date: 03/20/2023
- Last Update Date: 12/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 9830540053
- Enrollment ID: I20240111002708
Medical Identifiers
Medical identifiers for Kathleen Reilly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417659962 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | APRN03630 (Rhode Island) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Lifespan Physician Group Inc | 2567455082 | 669 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kathleen Reilly allows following entities to bill medicare on her behalf.
| Entity Name | Lifespan Physician Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548506793
PECOS PAC ID: 2567455082
Enrollment ID: O20130528000089 |
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| Entity Name | Me Psychotherapy, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043502214
PECOS PAC ID: 4183075302
Enrollment ID: O20240111002419 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathleen Reilly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kathleen Reilly,
194 Waterman St,
Providence, RI 02906-4015
Ph: (401) 633-2929 | Kathleen Reilly,
194 Waterman St,
Providence, RI 02906-4015
Ph: (401) 633-2929 |
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