Individual provider Active NPI

David Jefferson Reeder, M.D.

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1477937779
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A154806 Issued in CA
Practice address
101 The City Drive
Pavillion 1, 2ND Floor
Orange, CA 92868
Phone
(714) 456-7720
NPI assigned
Jul 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A154806 CA Primary

Addresses

Primary practice location

101 The City Drive
Pavillion 1, 2ND Floor
Orange, CA 92868

Mailing address

333 City Blvd W Ste 400
Orange, CA 92868-2994
Phone (714) 456-3870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20201026002154 AZ Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 1850622580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Arizona College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Tan Allergy and Asthma PCGroup PAC ID 1658309521, 4 clinicians

Practice addresses (Care Compare)

4915 E Baseline Rd
Suite 112
Gilbert, AZ 85234-2966
Phone (480) 626-6600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154806CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Tan Allergy and Asthma PC Allergy & Immunology CurrentSince Aug 4, 2023 Accepting new patients
Valley Allergy PLLC Allergy & Immunology PastSince Feb 1, 2024 Accepting new patients
Northern Arizona Pain Services LLC Past Accepting new patients

Locations

4915 E Baseline Rd
Ste 112
Gilbert, AZ 85234
Phone (480) 626-6600

708 E State Highway 260
Bldg B
Payson, AZ 85541

708 S Coeur D Alene Ln
Ste C
Payson, AZ 85541
Phone (602) 828-3777

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1477937779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W STE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682994",
            "telephone_number": "714-456-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DRIVE",
            "address_2": "PAVILLION 1, 2ND FLOOR",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "DAVID",
        "middle_name": "JEFFERSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-16",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A154806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.