NPIMap

Individual provider Active NPI

Desiree Reedus, M.D.

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1457437238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G84122 Issued in CA
Practice address
1200 Enclave Pkwy
Suite 200
Houston, TX 77077-1764
Phone
(281) 870-1000
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G84122 CA Primary

Addresses

Primary practice location

1200 Enclave Pkwy
Suite 200
Houston, TX 77077-1764

Mailing address

29995 Los Nogales Rd
Temecula, CA 92591-1821
Phone (951) 506-1013

Other identifiers 1

IdentifierTypeStateIssuer
84122OtherCAM.D. LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818001435 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 1052384823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Barbara County AuditorGroup PAC ID 9335052083, shared by 15 NPIs, 98 clinicians

Practice addresses (Care Compare)

2115 S Centerpointe Pkwy
Santa Maria, CA 93455-1334
Phone (805) 346-7230

300 N San Antonio Rd
Santa Barbara, CA 93110-1316
Phone (805) 681-5461

322 N San Antonio Rd
Santa Barbara, CA 93110-1316
Phone (805) 681-5220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G84122CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Behavioral Health CurrentSince Mar 30, 2021 Accepting new patients
Santa Barbara County Auditor Current Accepting new patients
County of Monterey Current Accepting new patients
Santa Barbara County Auditor CurrentSince Jul 3, 2023 Accepting new patients
County of Monterey Family Medicine CurrentSince Mar 30, 2021 Accepting new patients
Santa Barbara County Auditor CurrentSince Jul 3, 2023 Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Cogent Healthcare of California, PC Family Medicine Past Accepting new patients
Temecula Valley Cardiology Medical Group, Inc Past Accepting new patients
County of Monterey Past Accepting new patients

Locations

1441 Constitution Blvd
Bldg 151
Salinas, CA 93906
Phone (831) 755-8640

1615 Bunker Hill Way
Ste 140
Salinas, CA 93906

300 N San Antonio Rd
Rm 107
Santa Barbara, CA 93110
Phone (805) 681-5461

2115 Centerpointe Pkwy
Santa Maria, CA 93455
Phone (805) 346-7230

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61419

Organizations & group practices 10

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457437238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29995 LOS NOGALES RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925911821",
            "telephone_number": "951-506-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ENCLAVE PKWY",
            "address_2": "SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770771764",
            "telephone_number": "281-870-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDUS",
        "first_name": "DESIREE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G84122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D. LICENSE",
            "identifier": "84122",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.