Active NPI
Matthew Thomas Reynolds, D.O.
- Emergency Medicine Physician
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 266070
- Practice address
- 201 Lyons Ave
Newark, NJ 07112-2027 - Phone
- (973) 926-7000
- NPI assigned
- Apr 30, 2012
- Last updated
- Jun 21, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25MB10056800 | NJ | |
| Emergency Medicine Physician | 207P00000X | 266070 | NY | Primary |
Addresses
Primary practice location
201 Lyons Ave
Newark, NJ 07112-2027
Mailing address
9 Ebb Tide Landing
Poquoson, VA 23662
Phone (607) 972-7055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.91 of 100
- Quality
- 92.86
- Promoting interoperability
- 94.93
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB10056800 | NJ | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Riverside Physician Services Inc | Current | Accepting new patients | |
| Riverside Physician Services Inc | Emergency Medicine | Current | Accepting new patients |
Locations
1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200
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.
-
dba Riverside Gastroenterology Specialists
- Gastroenterology Physician
- Newport News, VA
- NPI 1194929026
-
dba Riverside Gastroenterology Specialists Williamsburg
- Gastroenterology Physician
- Williamsburg, VA
- NPI 1083867311
-
dba Riverside Emergency Physicians
- Emergency Medicine Physician
- Williamsburg, VA
- NPI 1639418429
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Riverside Regional Medical Center
- General Acute Care Hospital
- Newport News, VA
- NPI 1366547747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498003200000",
"number": "1366700122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 EBB TIDE LANDING",
"city": "POQUOSON",
"state": "VA",
"postal_code": "23662",
"telephone_number": "607-972-7055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122027",
"telephone_number": "973-926-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "MATTHEW",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-30",
"last_updated": "2017-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MB10056800",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "266070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.