MARGARET MARY O'REILLY MD
NPI 1255349718
Obstetrics & Gynecology in Portland, OR


Quality Rating: 95.23 out of 100 score

NPI Status: Active since August 03, 2006

Contact Information

3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239
Phone: (503) 494-4500

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  • Individual
  • Female
  • Years of Experience 31
  • Obstetrics & Gynecology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About MARGARET O'REILLY

This page provides the complete NPI Profile along with additional information for Margaret O'reilly, a women's health care provider established in Portland, Oregon with a medical specialization in Obstetrics & Gynecology and more than 31 years of experience. She graduated from Tulane University School Of Medicine in 1995. The healthcare provider is registered in the NPI registry with number 1255349718 assigned on August 2006. The practitioner's primary taxonomy code is 207V00000X with license number MD20578 (OR). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI
1255349718
Provider Name
MARGARET MARY O'REILLY MD
Gender
Female
Entity Type
Individual
Location Address
3181 SW SAM JACKSON PARK RD PORTLAND, OR 97239
Location Phone
(503) 494-4500
Mailing Address
7337 SE 36TH AVE PORTLAND, OR 97202
Medical School Name
TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year
1995
Is Sole Proprietor?
No
Enumeration Date
08-03-2006
Last Update Date
07-08-2007
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Women's health care providers like Margaret O'reilly treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

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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

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
MD20578
License State
OR
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Moda Health Affinity Bronze 7750 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Navigator Bronze 7000 Exchange - PPO
  • Navigator Bronze 9200 - PPO
  • Navigator Bronze HSA 8050 - PPO
  • Navigator Gold 1500 - PPO
  • Navigator Gold 1500 Exchange - PPO
  • Navigator Gold 500 Exchange - PPO
  • Navigator Silver 3500 Exchange - PPO
  • Navigator Silver 4000 Exchange - PPO
  • Navigator Silver 5000 - PPO
  • Navigator Silver HSA 3500 - PPO
  • HSA Qualified 7100 Bronze - Signature Network - EPO
  • HSA Qualified 7100 Bronze - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
  • Bronze HSA 7000 Individual and Family Network - EPO
  • Gold 2300 Individual and Family Network - EPO
  • Regence Standard Bronze Plan Individual and Family Network - EPO
  • Regence Standard Gold Plan Individual and Family Network - EPO
  • Regence Standard Silver Plan Individual and Family Network - EPO
  • Silver 6200 Individual and Family Network - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
H05876MEDICARE UPIN (02) 
181959MEDICAID (05)OR 

Medicare Participation & PECOS Enrollment Status

Margaret O'reilly is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Margaret 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

  • PECOS PAC ID: 5698834604

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20081105000854

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • 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 typical physician office visit costs for Medicare beneficiaries in this area are: $33.54 for a new patient copayment and $18.32 for an established patient copayment.

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 97239 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $134.16
  • Minimum New Patient Price $58.99
  • Maximum New Patient Price $176.88
  • Average New Patient Copayment $33.54
  • Minimum New Patient Copayment $14.74
  • Maximum New Patient Copayment $44.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $73.28
  • Minimum Established Patient Price $19.32
  • Maximum Established Patient Price $144.79
  • Average Established Patient Copayment $18.32
  • Minimum Established Patient Copayment $4.83
  • Maximum Established Patient Copayment $36.19

* 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.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95.23, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 95.23 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 75.74

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 100

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Margaret O'reilly is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
OHSU HOSPITAL AND CLINICS3181 SW SAM JACKSON PARK ROAD
PORTLAND, OR 97239
(503) 494-6245Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1255349718
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22105641872
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 0 + 5 + 6 + 4 + 1 + 8 + 7 + 2 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1255349718 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1972506301 JERRIS ROBERT HEDGES MD, MS, MMM
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD # L-102
PORTLAND, OR 97239
(503) 494-2767
1720082357DR. BRANDON ZANE HOROWITZ M.D.
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-4833
1770587222 MARY ANN BROWNING FNP
Individual
Nurse Practitioner (Family)3181 SW SAM JACKSON PARK RD CDW-EM
PORTLAND, OR 97239
(503) 494-7500
1427052166DR. ROBERT AUGUSTUS LOWE MD, MPH
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-7134
1629073895DR. MOHAMUD RAMZANALI DAYA MD, M S
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD MAILCODE CDW-EM
PORTLAND, OR 97239
(503) 494-7248
1720083991DR. RITU SAHNI MD
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD # CDW
PORTLAND, OR 97239
(503) 494-7500
1336144450DR. ALFREDO SABBAJ MD
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD MAIL CODE: CDW-EM
PORTLAND, OR 97239
(503) 494-1475
1467457192 ROBERT G HENDRICKSON MD
Individual
Emergency Medicine (Medical Toxicology)3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-9495
1912907908DR. JONATHAN JUI M.D.
Individual
Emergency Medicine3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-7500
1013918267DR. JAMES CHRISTOPHER AUSTIN MD
Individual
Urology (Pediatric Urology)3181 SW SAM JACKSON PARK RD PEDIATRIC UROLOGY CDW-6
PORTLAND, OR 97239
(503) 494-4808
1285626507 JENNIFER R ANTICK PHD
Individual
Psychologist (Clinical)3181 SW SAM JACKSON PARK RD UHN 80
PORTLAND, OR 97239
(503) 494-7353
1043206279MS. MICHELE PATRICIA MEGREGIAN CNM
Individual
Advanced Practice Midwife3181 SW SAM JACKSON PARK RD KPV7C
PORTLAND, OR 97239
(503) 418-4500
1285615781 SUSAN ROWELL M.D.
Individual
Surgery (Trauma Surgery)3181 SW SAM JACKSON PARK RD L611
PORTLAND, OR 97239
(503) 494-2400
1104809920 DAVID MARK SPIRO MD
Individual
Pediatrics (Pediatric Emergency Medicine)3181 SW SAM JACKSON PARK RD MAIL CODE CDW-EM
PORTLAND, OR 97239
(503) 494-0828
1457337123MR. PETER CHORDAS FNP-C
Individual
Nurse Practitioner3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-1368
1174509897DR. PASCALE M SCHWAB M.D.
Individual
Internal Medicine (Rheumatology)3181 SW SAM JACKSON PARK RD OP09
PORTLAND, OR 97239
(503) 494-8963
1104896786DR. STEVEN JOHN SKOOG
Individual
Urology (Pediatric Urology)3181 SW SAM JACKSON PARK RD CDW6
PORTLAND, OR 97239
(503) 494-4808
1760456925DR. CRAIGAN TODD USHER MD
Individual
Psychiatry & Neurology (Psychiatry)3181 SW SAM JACKSON PARK RD MAIL CODE DC7P
PORTLAND, OR 97239
(503) 418-5775
1093780769DR. NORMAN A. COHEN MD
Individual
Anesthesiology3181 SW SAM JACKSON PARK RD UHS-2
PORTLAND, OR 97239
(503) 494-7641
1285609917DR. DAWN LYNN NOLT MD
Individual
Pediatrics (Pediatric Infectious Diseases)3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239
(503) 494-9690

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1255349718, enumerated in the NPI registry as an "individual" on August 03, 2006

The provider is located at 3181 Sw Sam Jackson Park Rd Portland, Or 97239 and the phone number is (503) 494-4500

The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X

The provider has more than 31 years of experience. She graduated from Tulane University School Of Medicine in 1995.

The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.

Medicare beneficiaries should expect a typical cost of $134.16 with an average copayment of $33.54 for new patient appointments. Established patients should expect a typical charge of $73.28 and an average copayment of 18.32. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): OHSU HOSPITAL AND CLINICS. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on August 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.