Active NPI
Derrece K Reid, M.D.
- Neurology Physician
- West Islip, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 279921
- Practice address
- 1175 Montauk Highway, Suite 6
West Islip, NY 11795-4939 - Phone
- (833) 744-6333
- Fax
- (516) 433-1036
- NPI assigned
- Jun 25, 2010
- Last updated
- Jul 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MT198306 | PA | |
| Neurology Physician | 2084N0400X | 279921 | NY | Primary |
Addresses
Primary practice location
1175 Montauk Highway, Suite 6
West Islip, NY 11795-4939
Mailing address
PO Box 100
West Islip, NY 11795-4939
Phone (833) 774-6333
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Howard University College of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1111 Montack Hwy
West Islip, NY 11795-4910
Phone (631) 376-6185
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHS Physician Partners, P.C | Current | Accepting new patients | |
| Albany Medical College | Current | Accepting new patients | |
| Albany Medical College | Current | Accepting new patients | |
| CHS Physician Partners, PC | Current | Accepting new patients | |
| Albany Medical College | Internal Medicine | Current | Accepting new patients |
| Albany Medical College | Internal Medicine | Current | Accepting new patients |
| Albany Medical College | Neurology | Current | Accepting new patients |
Locations
47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773
1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012
100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800
1111 Montauk Hwy
West Islip, NY 11795
Phone (631) 422-2700
1175 Montauk Hwy
Ste 6
West Islip, NY 11795
Phone (631) 422-5371
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- dreid127671@direct-chsli.net
Organizations & group practices 7
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 Cardiac Interventional Group
- Interventional Cardiology Physician
- Fresh Meadows, NY
- NPI 1407089345
-
dba Albany Med EmUrgent Care
- Urgent Care Clinic/Center
- Albany, NY
- NPI 1386038925
-
dba Albany Medical College Department of Medicine
- Allergy & Immunology Physician
- Albany, NY
- NPI 1386689248
-
dba Albany Medical College Dept of PM&R
- Physical Medicine & Rehabilitation Physician
- Albany, NY
- NPI 1629008537
Internal Medicine
-
dba Albany Medical College Dept of Neurology
- Neurology Physician
- Albany, NY
- NPI 1811921786
-
- Cardiovascular Disease Physician
- Roslyn, NY
- NPI 1164585725
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Islip, NY
- NPI 1902865355
-
dba St. Charles Hospital
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1164481529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562716800000",
"number": "1457662256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954939",
"telephone_number": "833-774-6333",
"fax_number": "516-433-1036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 MONTAUK HIGHWAY, SUITE 6",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954939",
"telephone_number": "833-744-6333",
"fax_number": "516-433-1036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "DERRECE",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-25",
"last_updated": "2019-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MT198306",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "279921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.