Individual provider Active NPI

Paul M Reiter, M.D.

  • Cardiovascular Disease Physician
  • Kingston, NY
National Provider Identifier
1033101019
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
136910 Issued in NY
Practice address
111 Marys Ave
Suite 3
Kingston, NY 12401-5852
Phone
(845) 339-3663
Fax
(845) 339-3629
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 136910 NY Primary

Addresses

Primary practice location

111 Marys Ave
Suite 3
Kingston, NY 12401-5852

Mailing address

111 Marys Ave
Suite 3
Kingston, NY 12401-5852
Phone (845) 339-3663

Other identifiers 1

IdentifierTypeStateIssuer
00707319MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
136910NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Dutchess Hospital PastSince Jun 1, 2018 Accepting new patients
Prime Care Physicians, P.L.L.C. Cardiovascular Disease Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1033101019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MARYS AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015852",
            "telephone_number": "845-339-3663",
            "fax_number": "845-339-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MARYS AVE",
            "address_2": "SUITE 3",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015852",
            "telephone_number": "845-339-3663",
            "fax_number": "845-339-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITER",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "136910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00707319",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.