Reo Malachi Peniston, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

264985-1 Issued in NY

Practice address

1296 W Broad St
Groveland, FL 34736-2012

Phone

(407) 905-8827

Fax

(352) 429-5606

NPI assigned

Jun 9, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, FL2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Centers, IncGroup PAC ID 4082515390, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mederi Caretenders Home health agency, Clermont, FL, CCN 107470
• Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: reo.peniston@chcfl.eclinicaldirectplus.com

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.

• Community Health Centers, Inc

  • Community/Retail Pharmacy
  • Apopka, FL
  • NPI 1134258684
  Medicare reassignment Care Compare group NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Community Health Centers, Inc

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1396829677
  NPD
• Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1710259965
  NPD
• Community Health Centers, Inc

  • Primary Care Clinic/Center
  • Orlando, FL
  • NPI 1831273119
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD
• Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Orlando, FL
  • NPI 1366531618
  NPD (past)
• Ny Acute Care Specialists PC

  • Hospitalist Physician
  • Rome, NY
  • NPI 1528377892
  NPD (past)

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

• LHCG Cliv, LLC

  • Home Health Agency
  • Clermont, FL
  • NPI 1063045961
  Care Compare affiliation
• South Lake Hospital, Inc.

  • General Acute Care Hospital
  • Clermont, FL
  • NPI 1336221019
  Care Compare affiliation

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1093974511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WOODLAND ST",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873546",
            "telephone_number": "407-905-8827",
            "fax_number": "407-905-8998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 W BROAD ST",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347362012",
            "telephone_number": "407-905-8827",
            "fax_number": "352-429-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENISTON",
        "first_name": "REO",
        "middle_name": "MALACHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-09",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "264985-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108872000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph WM Nussbaumer Jr., PH.D.
• Arnoldo Oliveros Lopez, FNP-BC
• Hafusat Abosede Oni, DO
• Kendra Ortega Leon
• Connie Ortiz
• Beatriz Perez, ARPN
• Pinnacle Land Services Corporation
• Melissa Pion
• Flavia Pirani Silva
• Shana Runnels Pittman, LCSW

• Family Medicine Physician in Groveland, FL
• Providers in Groveland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.