Individual provider Active NPI

Michael J Rekas, D.O.

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1174525570
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO295 Issued in RI
Practice address
1567 Centerville Rd
Warwick, RI 02886-4251
Phone
(401) 821-5022
Fax
(401) 821-4451
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO295 RI Primary

Addresses

Primary practice location

1567 Centerville Rd
Warwick, RI 02886-4251

Mailing address

1567 Centerville Rd
Warwick, RI 02886-4251
Phone (401) 821-5022

Other identifiers 1

IdentifierTypeStateIssuer
9003259MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20100902000248 RI Practitioner - Family Practice 5496879108 Practice locations: Warwick, RI

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO295RIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1174525570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864251",
            "telephone_number": "401-821-5022",
            "fax_number": "401-821-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 CENTERVILLE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864251",
            "telephone_number": "401-821-5022",
            "fax_number": "401-821-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REKAS",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003259",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.