Individual provider Active NPI

Carlos Albert Reck, M.D.

  • Pediatric Surgery Physician
  • New York, NY
National Provider Identifier
1245613652
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
305119 Issued in NY
Practice address
965 5TH Ave Ofc 1a
New York, NY 10075-1721
Phone
(718) 749-1249
NPI assigned
Jul 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0120X 305119 NY Primary

Addresses

Primary practice location

965 5TH Ave Ofc 1a
New York, NY 10075-1721

Mailing address

965 5TH Ave Ofc 1a
New York, NY 10075-1721
Phone (187) 491-2497

Other identifiers 1

IdentifierTypeStateIssuer
07872159MedicaidNY

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
I20240322003570 NY Practitioner - Pediatric Medicine 7719280411 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians of Brooklyn, Inc. Multi-Specialty CurrentSince Feb 12, 2024 Accepting new patients
University Physicians of Brooklyn, Inc. Multi-Specialty CurrentSince Feb 12, 2024 Accepting new patients
University Hospital of Brooklyn Suny Downstate Health Sciences Univers Past Accepting new patients

Locations

450 Clarkson Ave
#80
Brooklyn, NY 11203
Phone (718) 613-8481

450 Clarkson Ave
Brooklyn, NY 11203
Phone (718) 270-1603

Interoperability endpoints

  • Direct secure messaging: carlos.reck.1@438.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1245613652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 5TH AVE OFC 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751721",
            "telephone_number": "187-491-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 5TH AVE OFC 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751721",
            "telephone_number": "718-749-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECK",
        "first_name": "CARLOS",
        "middle_name": "ALBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-02",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "305119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07872159",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.