Individual provider Active NPI

Margaret E Reidy, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Broomfield, CO
National Provider Identifier
1346263688
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DR.0066404 Issued in CO
Practice address
11820 Destination Dr
Broomfield, CO 80021-2518
Phone
(303) 464-4940
Fax
(303) 460-6193
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD037498E PA
Physical Medicine & Rehabilitation Physician 208100000X DR.0066404 CO Primary

Addresses

Primary practice location

11820 Destination Dr
Broomfield, CO 80021-2518

Mailing address

11820 Destination Dr
Broomfield, CO 80021-2518
Phone (303) 464-4940

Other practice location 1

9365 McKnight Rd
Suite 300
Pittsburgh, PA 15237-5956
Phone (412) 366-8377

Other identifiers 1

IdentifierTypeStateIssuer
0011910500015MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0066404COMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Medicine & Rehabilitation Experts Physical Medicine & Rehabilitation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1346263688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11820 DESTINATION DR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212518",
            "telephone_number": "303-464-4940",
            "fax_number": "303-460-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 DESTINATION DR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212518",
            "telephone_number": "303-464-4940",
            "fax_number": "303-460-6193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9365 McKnight Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152375956",
            "country_code": "US",
            "telephone_number": "412-366-8377",
            "fax_number": "412-630-9761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDY",
        "first_name": "MARGARET",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD037498E",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR.0066404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011910500015",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.