Organization Active NPI

Duane Reade

  • Pharmacy
  • Roosevelt Island, NY
National Provider Identifier
1124044235
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
025412 Issued in NY
Legal business name
DUANE READE
Practice address
425 Main St
Roosevelt Island, NY 10044-0238
Phone
(646) 521-2260
Fax
(646) 521-2264
NPI assigned
Jul 14, 2006
Organization subpart
Yes
Parent organization
WALGREENS HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Authorized official

Name
Jennifer Ponce
Title
Manager
Phone
(847) 527-2489

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X 025412 NY Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

425 Main St
Roosevelt Island, NY 10044-0238

Mailing address

1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (847) 527-2489

Other identifiers 2

IdentifierTypeStateIssuer
3325708OtherOTHER ID NUMBER-COMMERCIAL NUMBER
02291990MedicaidNY

Other names 1

  • DUANE READE #14386 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930098473 NY DME Supplier - Pharmacy 3971644642 Practice locations: Roosevelt Island, NY
O20120222000409 TX Part B Supplier - Centralized Flu Biller 3971644642 This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2293944Duane Reade No 14386425 Main St, New York, NY 10044Certificate of waiverMar 26, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Duane Reade425 Main St, Roosevelt Island, NY 10044-0238(646) 521-2260 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Aug 1, 2011

National Provider Directory

National Provider Directory
Part of
Walgreens Holding Company

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781568000000",
    "number": "1124044235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 E VOORHEES ST",
            "address_2": "MS 790",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618344509",
            "telephone_number": "847-527-2489",
            "fax_number": "217-709-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MAIN ST",
            "city": "ROOSEVELT ISLAND",
            "state": "NY",
            "postal_code": "100440238",
            "telephone_number": "646-521-2260",
            "fax_number": "646-521-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE READE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALGREENS HOLDING COMPANY",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-527-2489"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "025412",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3325708",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02291990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DUANE READE #14386",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DUANE READE #14386",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roosevelt Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.