Active NPI
Duane Reade
- Pharmacy
- Rego Park, NY
National Provider Identifier
1295750768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 024183
- Legal business name
- DUANE READE
- Practice address
- 9511 63Rd Dr
Rego Park, NY 11374-2024 - Phone
- (718) 897-0803
- Fax
- (718) 897-0804
- NPI assigned
- Jul 13, 2006
- Organization subpart
- Yes
- Parent organization
- WALGREENS HOLDING COMPANY
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Ponce
- Title
- Manager
- Phone
- (847) 527-2489
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | 024183 | NY | Primary |
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
9511 63Rd Dr
Rego Park, NY 11374-2024
Mailing address
1901 E Voorhees St
Ms 790
Danville, IL 61834-4509
Phone (847) 527-2489
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01900090 | Medicaid | NY | |
| 3301405 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- DUANE READE #14477
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, TX
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930057329 | NY | DME Supplier - Pharmacy | 3971644642 | Practice locations: Rego Park, NY |
| O20120222000409 | TX | Part B Supplier - Centralized Flu Biller | 3971644642 | This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2213497 | Duane Reade Drug Store #14477 | Certificate of waiver | Mar 26, 2027 |
| 33D2293576 | Duane Reade No 14477 | Certificate of waiver | Mar 26, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Duane Reade | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) | Accepts assignment |
National Provider Directory
National Provider Directory- Part of
- Walgreens Holding Company
Member of 4
Organizations this organization is a member of, according to the National Provider Directory.
Locations
9511 63rd Dr
Rego Park, NY 11374
Phone (718) 897-0803
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Rego Park, NY
- NPI 1750565321
-
- Pharmacist
- Rego Park, NY
- NPI 1972974962
-
- Pharmacist
- Rego Park, NY
- NPI 1750551701
-
- Pharmacist
- Rego Park, NY
- NPI 1306148077
-
- Pharmacist
- Rego Park, NY
- NPI 1194057612
-
- Pharmacist
- Rego Park, NY
- NPI 1295527752
-
- Pharmacist
- Rego Park, NY
- NPI 1396913919
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781568000000",
"number": "1295750768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 E VOORHEES ST",
"address_2": "MS 790",
"city": "DANVILLE",
"state": "IL",
"postal_code": "618344509",
"telephone_number": "847-527-2489",
"fax_number": "217-709-2344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9511 63RD DR",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742024",
"telephone_number": "718-897-0803",
"fax_number": "718-897-0804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DUANE READE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALGREENS HOLDING COMPANY",
"enumeration_date": "2006-07-13",
"last_updated": "2026-06-16",
"certification_date": "2026-06-16",
"status": "A",
"authorized_official_last_name": "PONCE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "847-527-2489"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "NY",
"license": "024183",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01900090",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "3301405",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "DUANE READE #14477",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "DUANE READE #14477",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.