Individual provider Active NPI

Lisa J Reeves, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1154305746
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
201469 Issued in NY
Practice address
1621 Eastchester Rd
CFCC
Bronx, NY 10461-2604
Phone
(718) 405-8040
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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 201469 NY Primary

Addresses

Primary practice location

1621 Eastchester Rd
CFCC
Bronx, NY 10461-2604

Mailing address

1621 Eastchester Rd
CFCC
Bronx, NY 10461-2604
Phone (718) 405-8040

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
I20090814000014 NY Practitioner - Internal Medicine 3870647548 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201469NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Internal Medicine CurrentSince Jul 1, 2009 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2009 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

305 E 161st St
Bronx, NY 10451
Phone (718) 410-4711

1621 Eastchester Rd
Bronx, NY 10461

356 W 18th St
New York, NY 10011

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1154305746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 EASTCHESTER RD",
            "address_2": "CFCC",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612604",
            "telephone_number": "718-405-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 EASTCHESTER RD",
            "address_2": "CFCC",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612604",
            "telephone_number": "718-405-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "201469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.