Individual provider Active NPI

Daniela Reid, MD

  • Psychiatry Physician
  • Phoenix, AZ
National Provider Identifier
1053467571
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
34764 Issued in AZ
Practice address
3540 E Baseline Rd Ste 150
Phoenix, AZ 85042-9630
Phone
(602) 323-3000
Fax
(602) 243-5390
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 34764 AZ
Psychiatry Physician 2084P0800X 34764 AZ Primary

Addresses

Primary practice location

3540 E Baseline Rd Ste 150
Phoenix, AZ 85042-9630

Mailing address

22618 N 70TH Dr
Glendale, AZ 85310-5928
Phone (623) 478-2870

Other practice location 1

159 W Wickenburg Way
Wickenburg, AZ 85390-2265
Phone (928) 668-0711

Other identifiers 1

IdentifierTypeStateIssuer
997950MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150909002582 AZ Practitioner - Psychiatry 5092746529 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34764AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc Current Accepting new patients
Community Intervention Associates, Inc. Current Accepting new patients
District Medical Group, Inc CurrentSince Jul 5, 2019 Accepting new patients
Lifewell Behavioral Wellness CurrentSince Apr 22, 2021 Accepting new patients
Community Intervention Assciates, Inc CurrentSince Dec 24, 2016 Accepting new patients
District Medical Group, Inc CurrentSince Jul 5, 2019 Accepting new patients
Community Intervention Associates, Inc CurrentSince Dec 24, 2016 Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients
St Lukes Behavioral Hospital LP Past Accepting new patients
Gatehouse Therapeutic Health Services Past Accepting new patients

Locations

275 W Continental Rd
Ste 141
Green Valley, AZ 85622
Phone (520) 400-9229

275 W Continental Rd
Green Valley, AZ 85622
Phone (520) 625-4401

6915 E Main St
Ste 200
Mesa, AZ 85207

1516 S Ocotillo Ave
Parker, AZ 85344
Phone (928) 669-5319

202 E Earll Dr
Ste 200
Phoenix, AZ 85012
Phone (602) 599-5404

2715 N 3rd St
Phoenix, AZ 85004
Phone (602) 264-4331

5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000

3540 E Baseline Rd
Ste 150
Phoenix, AZ 85042
Phone (480) 739-5784

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

1773 W Saint Marys Rd
Ste 102
Tucson, AZ 85745
Phone (520) 622-8357

2851 S Avenue B
Bldg 4
Yuma, AZ 85364
Phone (928) 919-2436

Interoperability endpoints

  • Direct secure messaging: daniela.reid.p1@direct.lifewell.nextgenshare.com

Organizations & group practices 10

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1053467571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22618 N 70TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105928",
            "telephone_number": "623-478-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 E BASELINE RD STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850429630",
            "telephone_number": "602-323-3000",
            "fax_number": "602-243-5390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 W Wickenburg Way",
            "address_purpose": "LOCATION",
            "city": "Wickenburg",
            "state": "AZ",
            "postal_code": "853902265",
            "country_code": "US",
            "telephone_number": "928-668-0711",
            "fax_number": "928-684-6852",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "DANIELA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "AZ",
            "license": "34764",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "34764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "997950",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.