Individual provider Active NPI

Joseph S Reiss, MD

  • Allergy & Immunology Physician
  • Wantagh, NY
National Provider Identifier
1376526863
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
96802 Issued in NY
Practice address
1492 Wantagh Ave
Wantagh, NY 11793-2204
Phone
(512) 221-6565
Fax
(516) 221-0298
NPI assigned
Nov 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 96802 NY Primary

Addresses

Primary practice location

1492 Wantagh Ave
Wantagh, NY 11793-2204

Mailing address

1492 Wantagh Ave
Wantagh, NY 11793-2204
Phone (512) 221-6565

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
I20100618000000 NY Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 6507996584 Practice locations: Wantagh, NY

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
State University of New York Downstate Medical Center, 1966
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1492 Wantagh Ave
Wantagh, NY 11793-2225
Phone (516) 221-6565

33 Bayberry Rd
Lawrence, NY 11559-2724

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
96802NYMDAllergy & Immunology Physician

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1376526863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932204",
            "telephone_number": "512-221-6565",
            "fax_number": "516-221-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 WANTAGH AVE",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932204",
            "telephone_number": "512-221-6565",
            "fax_number": "516-221-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "JOSEPH",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "96802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wantagh, NY

Sources for this page

Verify at the official NPI Registry.