Individual provider Active NPI

Megan Reisert, RPA-C

  • Physician Assistant
  • Mineola, NY
National Provider Identifier
1194005272
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
014942-1 Issued in NY
Practice address
259 1St St
Mineola, NY 11501-3957
Phone
(516) 663-0333
NPI assigned
Aug 22, 2011
Last updated
Jun 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 014942-1 NY Primary
Medical Physician Assistant 363AM0700X 014942-1 NY
Surgical Physician Assistant 363AS0400X 014942-1 NY

Addresses

Primary practice location

259 1St St
Mineola, NY 11501-3957

Mailing address

125 Lincoln Ave
Apartment B3F
Mineola, NY 11501-2824
Phone (978) 621-4445

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140123001290 NY Practitioner - Physician Assistant 2163650961 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014942-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Feb 1, 2025 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 27, 2013 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

196 Merrick Rd
Oceanside, NY 11572
Phone (516) 255-1616

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: megan.reisert@4018.securemail.prognocis.com
  • Direct secure messaging: mreisert169354@direct.optum.com

Organizations & group practices 7

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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1194005272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 LINCOLN AVE",
            "address_2": "APARTMENT B3F",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012824",
            "telephone_number": "978-621-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISERT",
        "first_name": "MEGAN",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "014942-1",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014942-1",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "014942-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.