JAMES RIELLY NPI 1386638005

NPI Information

NPI: 1386638005
Provider Name: JAMES RIELLY
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

PECOS Registration: Yes

Address:
395 W COUGAR BLVD STE 503
PROVO, UT
ZIP 84604
Phone: (801) 374-9100
Get Directions

James Rielly is a vascular surgery surgery in Provo, UT with 37 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. James Rielly NPI is 1386638005. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1987

The provider's business location address is:

395 W COUGAR BLVD STE 503
PROVO, UT
ZIP 84604-323
Phone: (801) 374-9100
Fax: (801) 374-9117

The NPI 1386638005 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/8/2005 and was last updated on 3/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		249582	NEW YORK	No
2	2086S0129X	Surgery	Vascular Surgery	MD469103	PENNSYLVANIA	No
3	2086S0129X	Surgery	Vascular Surgery	83219	SOUTH CAROLINA	No
4	2086S0129X	Surgery	Vascular Surgery	11889299-1205	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	832193	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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