Individual provider Active NPI

Reem Wassef

  • Pediatrics Physician
  • Gainesville, FL
National Provider Identifier
1336763382
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME168482 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-7280
Phone
(352) 627-9350
NPI assigned
Jun 5, 2020
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301506634 MI
Pediatrics Physician 208000000X ME168482 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-7280

Mailing address

2055 E 14 Mile Rd
Birmingham, MI 48009-7280

Other practice location 1

2055 E 14 Mile Rd
Birmingham, MI 48009-7280
Phone (248) 645-1740

Other identifiers 1

IdentifierTypeStateIssuer
123629200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240905000033 FL Practitioner - Pediatric Medicine 0042631574 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301506634MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bloom Pediatrics PC Pediatrics CurrentSince Jun 1, 2022 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 19, 2024 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Aug 19, 2024 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

133 SW 130th Way
Ste C
Newberry, FL 32669
Phone (352) 594-1500

2055 E 14 Mile Rd
Birmingham, MI 48009
Phone (248) 645-1740

Interoperability endpoints

  • Direct secure messaging: rwassef730093@direct.shands.ufl.edu
  • Direct secure messaging: rwassef951584@direct.hfhs.org

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1336763382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E 14 MILE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480097280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326107280",
            "telephone_number": "352-627-9350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 E 14 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "MI",
            "postal_code": "480097280",
            "country_code": "US",
            "telephone_number": "248-645-1740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSEF",
        "first_name": "REEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301506634",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME168482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123629200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.