Alan Mario Reza Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

24 Magothy Beach Rd
Pasadena, MD 21122-4414

Phone

(410) 255-2700

NPI assigned

Sep 27, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maryland Primary Care Physicians, LLCGroup PAC ID 8729981832, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Maryland Primary Care Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Annapolis, MD
  • NPI 1083667067
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1396469938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 220",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763210",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAGOTHY BEACH RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224414",
            "telephone_number": "410-255-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZA",
        "first_name": "ALAN",
        "middle_name": "MARIO",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-27",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlada Ann Razmus, LCPC
• Gwynedd Morgwyn Reece, CRNP
• Renewed Hope Inc
• Renewed Hope Treatment and Wellness Center LLC
• S Peter Resta, PH.D.
• Wilkie Nickie Heiner Clores Ricalde
• Ricardo J Osorno MD LLC
• Virginia Ricketts, LCPC
• Kathryn Sydney Ricks, DPT
• Ritchie Drugs LLC (Mike's Pharmacy III)

• Physician Assistant in Pasadena, MD
• Providers in Pasadena, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.

Verify at the official NPI Registry.