Individual provider Active NPI

Edward Lewis Reason, D.O.

  • Internal Medicine Physician
  • Gouverneur, NY
National Provider Identifier
1033233879
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
167037-1 Issued in NY
Practice address
77 W Barney St
Gouverneur, NY 13642-1040
Phone
(315) 287-3400
Fax
(315) 287-0998
NPI assigned
Mar 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 167037-1 NY Primary

Addresses

Primary practice location

77 W Barney St
Gouverneur, NY 13642-1040

Mailing address

77 W Barney St
P.O. Box 149
Gouverneur, NY 13642-1040
Phone (315) 287-3400

Other identifiers 1

IdentifierTypeStateIssuer
00971513MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080702000143 NY Practitioner - Internal Medicine 7113099433 Reassigns benefits to 1 organization
Practice locations: Gouverneur, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

77 W Barney St
Gouverneur, NY 13642-1040
Phone (315) 287-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
167037-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delphi Hospitalist Services LLC CurrentSince Aug 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

77 W Barney St
Gouverneur, NY 13642
Phone (315) 287-1000

191 N Main St
Wellsville, NY 14895
Phone (585) 593-1100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033233879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "address_2": "P.O. BOX 149",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-287-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421040",
            "telephone_number": "315-287-3400",
            "fax_number": "315-287-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REASON",
        "first_name": "EDWARD",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "167037-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00971513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gouverneur, NY

Sources for this page

Verify at the official NPI Registry.