Individual provider Active NPI

Lydia M Jorge Reynolds, MD

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1114108552
Registry record updated Aug 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME96171 Issued in FL
Practice address
1611 NW 12TH Ave
Box 016960
Miami, FL 33136-1005
Phone
(305) 585-8256
Fax
(305) 243-8470
NPI assigned
Nov 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME96171 FL Primary
Pediatric Anesthesiology Physician 207LP3000X ME96171 FL

Addresses

Primary practice location

1611 NW 12TH Ave
Box 016960
Miami, FL 33136-1005

Mailing address

1611 NW 12TH Ave
Box 016960
Miami, FL 33136-1005
Phone (305) 585-8256

Other identifiers 1

IdentifierTypeStateIssuer
2803381-00MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20080325000441 FL Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 9638255177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
Meharry Medical College School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1601 NW 12TH Ave
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FL
Miami, FL 33136-1005

1601 NW 12TH Ave 1St FLR
Miami, FL 33136-1005

1601 NW 12TH Ave Room
2060 MCCD
Miami, FL 33136-1005
Phone (305) 585-5635

1601 NW 12TH Avenue 5065 /
5TH Mailman Center for Child Development
Miami, FL 33136-1005
Phone (305) 243-6251

1611 NW 12 Ave
Miami, FL 33136-1005

1611 NW 12 TH Ave
Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH
3B Jackson Memorial Hospital Acc West
Miami, FL 33136-1005
Phone (305) 585-7476

1611 NW 12TH Ave 2ND FL
Miami, FL 33136-1005

1611 NW 12TH Ave 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave 5TH Floor
Acc Clinic West JMH
Miami, FL 33136-1005
Phone (305) 243-4211

1611 NW 12TH Ave Acc E
Miami, FL 33136-1005

1611 NW 12TH Ave Acc E 2ND FLR
Miami, FL 33136-1005

1611 NW 12TH Ave Acc W
Miami, FL 33136-1005

1611 NW 12TH Ave Acc West
Miami, FL 33136-1005

1611 NW 12TH Ave Central
Miami, FL 33136-1005

1611 NW 12TH Ave DTC 1St FLR
JMH
Miami, FL 33136-1005
Phone (305) 585-6970

1611 NW 12TH Ave E
6006 Holtz Children'S Hospital
Miami, FL 33136-1005
Phone (904) 697-3945

1611 NW 12TH Ave FL
3 Acc W. Jackson Memorial Hospital
Miami, FL 33136-1005
Phone (305) 355-5000

1611 NW 12TH Ave JMH
Miami, FL 33136-1005

1611 NW 12TH Ave JMH 5TH FL
Acc West
Miami, FL 33136-1005
Phone (305) 689-7303

1611 NW 12TH Ave N Wing
Miami, FL 33136-1005

1611 NW 12TH Ave-Nicu
JMH Holtz Children'S Hospital
Miami, FL 33136-1005
Phone (305) 547-1496

1801 NW 9TH Ave 5TH FL
Miami, FL 33136-1125

1801 NW 9TH Ave 5TH FLR
Miami, FL 33136-1125

Hospital & facility affiliations

  • Univ of Miami Hospital and Clinics-Sylvester Compr Hospital, Miami, FL, CCN 100079

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Current Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
#300
Miami, FL 33136
Phone (305) 585-6970

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
#16960
Miami, FL 33136
Phone (305) 243-6358

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: ljorge40268@direct.med.miami.edu

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.

Hospital & facility affiliations 1

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": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439424000000",
    "number": "1114108552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-8256",
            "fax_number": "305-243-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "BOX 016960",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-8256",
            "fax_number": "305-243-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGE REYNOLDS",
        "first_name": "LYDIA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2015-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME96171",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "FL",
            "license": "ME96171",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2803381-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.