SAMANTHA R. REILLY (NP) – Nurse Practitioner, NPI 1043965924

SAMANTHA R. REILLY (NP) is a healthcare provider. based in South portland, Maine. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. CNP202220 (ME). The NPI Number for SAMANTHA R. REILLY (NP) is 1043965924

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA R. REILLY (NP)
NPI
1043965924
Phone
(207) 874-1489
Address
100 Foden Rd East, Ste 203
Enumeration Date
18 February 2022
Last Update Date
4 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2075233900
Graduation Year
2020 (6 years ago)
PAC ID
2860888559
Group Practice PAC ID
5092605261
Professional Enrollment ID
I20220406000112
Address ID
ME041062327SO100XXWXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

1,871 NURSE PRACTITIONER in ME

Provider Addresses for SAMANTHA R. REILLY (NP)

  • 100 Foden Rd East, Ste 203

    South Portland, ME 04106

    Phone: (207) 874-1489

    Fax: (207) 523-8590

    Type: Location

  • 100 FODEN RD EAST, STE 203

    SOUTH PORTLAND, ME 04106

    Phone: (207) 874-1489

    Fax: (207) 523-8590

    Type: Location

  • 100 GANNETT DR STE C

    SOUTH PORTLAND, ME 041065900

    Phone: (207) 347-2947

    Fax: (207) 874-2317

    Type: Mailing

  • 84 MARGINAL WAY STE 800

    PORTLAND, ME 041012475

    Phone: (207) 347-2947

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220406000112INurse PractitionerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes4535$0
99213Established patient office or other outpatient visit, 20-29 minutes3533$0
View full utilization report →

Insurance plans in this area (ZIP 04106)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5092605261View full group profile
NameSpecialtyState
-ME
O B S T E T R I C S/ G Y N E C O L O G YCO
Internal MedicineRI
Nurse PractitionerME
Sports MedicineME
Nurse PractitionerME
Family PracticeRI
-ME
-ME
-ME

Reviews

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Frequently asked questions

What unique ID ties claims to SAMANTHA R. REILLY (NP)?
NPI 1043965924 is assigned to SAMANTHA R. REILLY (NP) under the national enumeration system.
Does this profile mean SAMANTHA R. REILLY (NP) is currently active?
Yes — SAMANTHA R. REILLY (NP) appears active in the national provider directory.
What field does SAMANTHA R. REILLY (NP) work in?
You can think of SAMANTHA R. REILLY (NP) as practicing within Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does SAMANTHA R. REILLY (NP) practice in Maine?
You will see South Portland, Maine on file for SAMANTHA R. REILLY (NP) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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