Reena Kuriacose, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD183553 Issued in OR

Practice address

4010 Aerial Way
Eugene, OR 97402-9757

Phone

(541) 687-6349

Fax

(541) 242-8361

NPI assigned

May 30, 2007

Last updated

Dec 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Reena Panickaveetil Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Medical Education Assistance Corporation

  dba ETSU Physicians and Associates

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1225239908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-718-1000",
            "fax_number": "336-718-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 AERIAL WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029757",
            "telephone_number": "541-687-6349",
            "fax_number": "541-242-8361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Charlois Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271031508",
            "country_code": "US",
            "telephone_number": "336-718-1000",
            "fax_number": "336-718-1052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURIACOSE",
        "first_name": "REENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-00216",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD183553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REENA",
            "last_name": "PANICKAVEETIL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Devon Kunko
• Patricia Elaine Kuntz, M.S., LPC
• Taylor Kuntz
• Walter Benjamin Kunz, M.D.
• Yayoe Gail Kuramitsu, LCSW
• Robert T. Kurlychek, PH.D.
• Madeline Elizabeth Kurt, OTR/L
• Harriet Elizabeth Kurzejeski
• Kyle M Kurzet, MD
• Kelly Larson Kusak

• Internal Medicine Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.