Individual provider Active NPI

Reena Agarwal, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1275795114
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
230239 Issued in NY
Practice address
1276 Fulton Ave
Room 208
Bronx, NY 10456-3402
Phone
(718) 901-8918
NPI assigned
Jul 1, 2008
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 230239 NY Primary

Addresses

Primary practice location

1276 Fulton Ave
Room 208
Bronx, NY 10456-3402

Mailing address

1276 Fulton Ave
Room 208
Bronx, NY 10456-3402
Phone (718) 901-8918

Other identifiers 1

IdentifierTypeStateIssuer
02589155MedicaidNY

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
I20040824001451 NY Practitioner - Internal Medicine 3870567829 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230239NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Nov 3, 2015 Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Jul 1, 2008 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2008 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Feb 15, 2020 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Nov 3, 2015 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Feb 15, 2020 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

19 Bradhurst Ave
Ste 3100N
Hawthorne, NY 10532
Phone (914) 231-8373

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1275795114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "address_2": "ROOM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE",
            "address_2": "ROOM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGARWAL",
        "first_name": "REENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "230239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02589155",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.