Bruce E Reidenberg, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

169073 Issued in NY

Practice address

1 Stoneycrest Rd
Rye, NY 10580-4132

Phone

(914) 925-2597

NPI assigned

Apr 22, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Binghamton, NY
  • NPI 1316088941
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013135615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 STONEYCREST RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105804132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 STONEYCREST RD",
            "city": "RYE",
            "state": "NY",
            "postal_code": "105804132",
            "telephone_number": "914-925-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIDENBERG",
        "first_name": "BRUCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "169073",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "61086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graciela Ramos, LCSW
• Leslie Ramos
• Rachel Mara Ratner, CGC
• RBP Theall Rd, LLC
• Lizabeth Redfearn, RN
• Dorothy Reisner
• Jennifer Reisner, MSW, LCSW
• Helen Healey Rice
• Richard D Milone, M.D., P.C.
• Janusz R Richards, DC

• Pediatrics Physician in Rye, NY
• Providers in Rye, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.