Individual provider Active NPI

Nafisa Reza, M.D.

  • Psychiatry Physician
  • Glen Oaks, NY
National Provider Identifier
1164818555
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A162395 Issued in CA
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

Updated by the provider on May 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120002708 NY Order and Referring Only - PsychiatryPractitioner - Psychiatry 8224382635

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305059NYMDLicensed Practical Nurse
A162395CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.