Individual provider Active NPI

Derrece K Reid, M.D.

  • Neurology Physician
  • West Islip, NY
National Provider Identifier
1457662256
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
279921 Issued in NY
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, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002001956 NY Practitioner - Neurology 8325289549 Reassigns benefits to 2 organizations

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
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

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

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, P.C CurrentSince Jul 14, 2020 Accepting new patients
Albany Medical College CurrentSince Jul 15, 2015 Accepting new patients
Albany Medical College Current Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
Albany Medical College Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Albany Medical College Internal Medicine Current Accepting new patients
Albany Medical College Neurology CurrentSince Jul 15, 2015 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.