Individual provider Active NPI

Reese A Wain, MD

  • Vascular Surgery Physician
  • Mineola, NY
National Provider Identifier
1265414791
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
194340-1 Issued in NY
Practice address
120 Mineola Blvd
Suite 300
Mineola, NY 11501-4073
Phone
(516) 663-4400
Fax
(516) 663-4404
NPI assigned
Nov 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 194340-1 NY Primary

Addresses

Primary practice location

120 Mineola Blvd
Suite 300
Mineola, NY 11501-4073

Mailing address

120 Mineola Blvd
Suite 300
Mineola, NY 11501-4073
Phone (516) 663-4400

Other identifiers 1

IdentifierTypeStateIssuer
01863969MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

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
I20040511000610 NY Practitioner - Vascular Surgery 3173512407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Icahn School of Medicine at Mount Sinai, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

250 Patchogue Yaphank Rd
Suite 5
East Patchogue, NY 11772-4862
Phone (631) 654-3330

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

297 Mineola Blvd
Mineola, NY 11501-1502
Phone (516) 294-1377

77 Medford Ave
Patchogue, NY 11772-1281
Phone (631) 758-1910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
194340-1NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Montefiore Medical Center Past Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1825 Eastchester Rd
Bronx, NY 10461
Phone (718) 904-2000

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1111 Franklin Ave
Garden City, NY 11530
Phone (516) 222-8600

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

200 Old Country Rd
Ste 120
Mineola, NY 11501
Phone (516) 633-1220

120 Mineola Blvd
Ste 300
Mineola, NY 11501
Phone (516) 553-4400

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

77 Route 112
Patchogue, NY 11772
Phone (631) 207-2370

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

111 Broadway
Fl 2
Trinity, NY 10006
Phone (212) 263-9700

Networks

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

Interoperability endpoints

  • Direct secure messaging: rwain230565@nyumc.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1265414791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 300",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-4400",
            "fax_number": "516-663-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MINEOLA BLVD",
            "address_2": "SUITE 300",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014073",
            "telephone_number": "516-663-4400",
            "fax_number": "516-663-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAIN",
        "first_name": "REESE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "194340-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01863969",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.