Individual provider Active NPI

Reginald Rousseau, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bay Shore, NY
National Provider Identifier
1306822523
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
228851 Issued in NY
Practice address
340 Howells Rd
Bay Shore, NY 11706-5322
Phone
(833) 547-7463
Fax
(631) 248-5583
NPI assigned
Dec 20, 2005
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 228851 NY
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 228851 NY
Pain Medicine (Anesthesiology) Physician 207LP2900X 228851 NY Primary
Pain Medicine Physician 208VP0000X 228851 NY
Interventional Pain Medicine Physician 208VP0014X 228851 NY

Addresses

Primary practice location

340 Howells Rd
Bay Shore, NY 11706-5322

Mailing address

100 Motor Parkway
LL8
Hauppauge, NY 11788
Phone (833) 547-7463

Other practice location 1

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-6447

Other practice location 2

221 Jericho Tpke
Syosset, NY 11791-4515
Phone (516) 496-6447

Other practice location 3

1175 Montauk Hwy Ste 6
West Islip, NY 11795
Phone (631) 482-9977

Other practice location 4

4681 Veterans Memorial Hwy
Holbrook, NY 11741-4515
Phone (833) 547-7463

Other practice location 5

100 E Main St
Huntington, NY 11743-2847
Phone (833) 547-7463

Other practice location 6

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (833) 547-7463

Other identifiers 1

IdentifierTypeStateIssuer
02717366MedicaidNY

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
I20051229000192 NY Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 7315903952 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

400 Montauk Hwy
Suite 102
West Islip, NY 11795-4429
Phone (631) 533-2723

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
21.78 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228851NYMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meadowbrook Medical Associates Anesthesiology CurrentSince Jun 1, 2024 Accepting new patients
Gastrointestinal Care of Long Island PLLC CurrentSince Feb 19, 2024 Accepting new patients
Reginald M Rousseau MD PC Anesthesiology CurrentSince May 10, 2021 Accepting new patients
Rancocas Anesthesiology, P.a. Past Accepting new patients
Precision Radiation Oncology PC Past Accepting new patients
Atlanticare Regional Medical Center Anesthesiology Past Accepting new patients
Anesthesia Patient Services, PLLC Anesthesiology Past Accepting new patients
Cape Atlantic Radiation Oncology PC Past Accepting new patients

Locations

340 Howells Rd
Bay Shore, NY 11706
Phone (631) 666-1956

340 Howells Rd
Ste 2B
Bay Shore, NY 11706
Phone (631) 310-5071

801 Avenue N
Brooklyn, NY 11230
Phone (718) 627-6800

55 N Main St
Freeport, NY 11520
Phone (516) 352-8300

233 E Shore Rd
Ste 101
Great Neck, NY 11023
Phone (516) 480-2444

100 Motor Pkwy
Ste LL8
Hauppauge, NY 11788

4681 Veterans Memorial Hwy
Holbrook, NY 11741
Phone (631) 482-9977

187 Veterans Blvd
Massapequa, NY 11758
Phone (516) 795-5523

187 Veterans Blvd
#13202
Massapequa, NY 11758
Phone (516) 795-5523

5030 Broadway
New York, NY 10034
Phone (212) 567-9800

974 Route 45
Ste 2000
Pomona, NY 10970
Phone (845) 354-3700

136 Sagamore Rd
Tuckahoe, NY 10707
Phone (914) 337-6400

1488 Wantagh Ave
Wantagh, NY 11793
Phone (516) 785-1203

2155 Wantagh Ave
Wantagh, NY 11793
Phone (516) 785-1200

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

1175 Montauk Hwy
Ste 6
West Islip, NY 11795
Phone (631) 422-5371

865 Merrick Ave
Ste 150N
Westbury, NY 11590
Phone (516) 542-3636

Networks

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1306822523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOTOR PARKWAY",
            "address_2": "LL8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065322",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117914515",
            "country_code": "US",
            "telephone_number": "516-496-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "221 Jericho Tpke",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "117914515",
            "country_code": "US",
            "telephone_number": "516-496-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 Montauk Hwy Ste 6",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "11795",
            "country_code": "US",
            "telephone_number": "631-482-9977",
            "fax_number": "631-422-4169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4681 Veterans Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Holbrook",
            "state": "NY",
            "postal_code": "117414515",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 E Main St",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117432847",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954927",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUSSEAU",
        "first_name": "REGINALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "228851",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NY",
            "license": "228851",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "228851",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "228851",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "228851",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02717366",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.