Individual provider Active NPI

Gary Stuart Reiter, M.D.

  • Ophthalmology Physician
  • Newport Beach, CA
National Provider Identifier
1306804406
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G34721 Issued in CA
Practice address
1501 Superior Ave Ste 110
Newport Beach, CA 92663-3606
Phone
(949) 646-2471
Fax
(949) 642-4338
NPI assigned
May 1, 2006
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X G34721 CA Primary

Addresses

Primary practice location

1501 Superior Ave Ste 110
Newport Beach, CA 92663-3606

Mailing address

1501 Superior Ave Ste 110
Newport Beach, CA 92663-3606
Phone (949) 646-2471

Other identifiers 1

IdentifierTypeStateIssuer
00G347212MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120223000715 CA Practitioner - Ophthalmology 9830357755 Practice locations: Newport Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Irvine, California College of Medicine, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1501 Superior Ave
Suite 110
Newport Beach, CA 92663-3606
Phone (949) 646-2471

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Restorative Performance Physical Therapy, Professional Corporation PastSince Dec 31, 2023 Accepting new patients

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, 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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1306804406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE STE 110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633606",
            "telephone_number": "949-646-2471",
            "fax_number": "949-642-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE STE 110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633606",
            "telephone_number": "949-646-2471",
            "fax_number": "949-642-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITER",
        "first_name": "GARY",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G34721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G347212",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.