Active NPI
Nafisa Reza, M.D.
- Psychiatry Physician
- Glen Oaks, NY
National Provider Identifier
1164818555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A162395
- Practice address
- 7559 263Rd St
Glen Oaks, NY 11004-1150 - Phone
- (718) 470-4032
- NPI assigned
- Apr 13, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | A162395 | CA | Primary |
Addresses
Primary practice location
7559 263Rd St
Glen Oaks, NY 11004-1150
Mailing address
890 Tallmadge Rd
Apartment #28
Kent, OH 44240-7300
Phone (330) 221-3444
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181120002708 | NY | Order and Referring Only - Psychiatry | 8224382635 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305059 | NY | MD | Licensed Practical Nurse |
| A162395 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York City Health and Hospitals Corporation | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- nreza1445201@nychhc.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Bellevue Hospital Center
- General Acute Care Hospital
- New York, NY
- NPI 1073535027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1164818555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 TALLMADGE RD",
"address_2": "APARTMENT #28",
"city": "KENT",
"state": "OH",
"postal_code": "442407300",
"telephone_number": "330-221-3444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7559 263RD ST",
"city": "GLEN OAKS",
"state": "NY",
"postal_code": "110041150",
"telephone_number": "718-470-4032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REZA",
"first_name": "NAFISA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A162395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glen Oaks, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.