Boris Reydel

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

59089 Issued in NJ

Practice address

6 Brighton Rd
2ND Floor
Clifton, NJ 07012-1647

Phone

(973) 777-7911

Fax

(973) 777-5403

NPI assigned

Jun 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Gastroenterology

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S General Hospital Hospital, Passaic, NJ, CCN 310006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: boris.reydel.1@2983.direct.athenahealth.com

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347
  Medicare reassignment Care Compare group NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  NPD
• Summit Medical Group, Inc

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - St. Mary'S Passaic LLC

  • General Acute Care Hospital
  • Passaic, NJ
  • NPI 1770901761
  Care Compare affiliation

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308182400000",
    "number": "1457394124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BRIGHTON RD",
            "address_2": "2ND FLOOR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121647",
            "telephone_number": "973-777-7911",
            "fax_number": "973-777-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BRIGHTON RD",
            "address_2": "2ND FLOOR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121647",
            "telephone_number": "973-777-7911",
            "fax_number": "973-777-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYDEL",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2011-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "59089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6155405",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph David Retik, LPC, CCH
• Revive Medical Group PC
• Nikil R Revuri, MD
• Rey Medicine PC
• Ricardo Rey, M.D.
• Emmanuel Reyes, MD
• Leslie Chari Reyes
• Maria Reyes
• Melinda Del Milagros Reyes, LCSW
• Diane S. Reyna, MS, CCC, SLP

• Gastroenterology Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2011; 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.