Active NPI
Denisse Reyes, MD
- Pediatrics Physician
- Stony Brook, NY
National Provider Identifier
1235591561
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA10645900
- Practice address
- Stony Brook Medicine Department of
HSC T-11, Room 040
Stony Brook, NY 11794-8111 - Phone
- (631) 444-2020
- NPI assigned
- Mar 25, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA10645900 | NJ | Primary |
Addresses
Primary practice location
Stony Brook Medicine Department of
HSC T-11, Room 040
Stony Brook, NY 11794-8111
Mailing address
321 State St
Perth Amboy, NJ 08861-4117
Phone (732) 719-4333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0719285 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA10645900 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tribeca Pediatrics, PLLC | Past | Accepting new patients | |
| Tribeca Pediatrics | Pediatrics | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- dreyes32166@tuftsmedicine.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Adolescent Medicine Physician
- New York, NY
- NPI 1588635171
-
- Pediatrics Physician
- Jersey City, NJ
- NPI 1356000160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1235591561",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 STATE ST",
"city": "PERTH AMBOY",
"state": "NJ",
"postal_code": "088614117",
"telephone_number": "732-719-4333",
"fax_number": "732-719-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "STONY BROOK MEDICINE DEPARTMENT OF",
"address_2": "HSC T-11, ROOM 040",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117948111",
"telephone_number": "631-444-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "DENISSE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-25",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA10645900",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0719285",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stony Brook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.