Individual provider Active NPI

Kathleen Reichard, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1255405874
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202821 Issued in NY
Practice address
1000 10TH Ave
New York, NY 10019-1147
Phone
(212) 523-6745
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB06152100 NJ
Pediatrics Physician 208000000X 202821 NY Primary

Addresses

Primary practice location

1000 10TH Ave
New York, NY 10019-1147

Mailing address

407 Airport Executive Park
Nanuet, NY 10954-5288

Other identifiers 1

IdentifierTypeStateIssuer
01847603MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070710000124 NJ Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 4385744192 Reassigns benefits to 4 organizations
I20210927001936 NY Practitioner - Emergency Medicine 4385744192 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB06152100NJMDEmergency Medicine Physician
202821NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Emergency Assoc PA Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Nyack Emergency Medical Association PLLC Emergency Medicine CurrentSince Sep 1, 2021 Accepting new patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Jun 9, 2010 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Oct 8, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC Pediatrics CurrentSince Oct 8, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Primary Care PC Pediatrics CurrentSince Jan 1, 2021 Accepting new patients
Yardmore Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Meridian Medical Group - Specialty Care, PC Pediatrics Past Accepting new patients
St Lukes Roosevelt Hospital Center Emergency Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

Interoperability endpoints

  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 9

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1255405874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 AIRPORT EXECUTIVE PARK",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109545288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 10TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191147",
            "telephone_number": "212-523-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHARD",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB06152100",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "202821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01847603",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.