Active NPI
Diane Crowley Reis, M.D.
- Psychiatry Physician
- West Lafayette, IN
National Provider Identifier
1487979563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01075683A
- Practice address
- 1241 Cumberland Ave Ste C
West Lafayette, IN 47906-1304 - Phone
- (765) 380-8447
- Fax
- (765) 356-9684
- NPI assigned
- Apr 1, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01075683A | IN | Primary |
Addresses
Primary practice location
1241 Cumberland Ave Ste C
West Lafayette, IN 47906-1304
Mailing address
1241 Cumberland Ave Ste C
West Lafayette, IN 47906-1304
Phone (765) 380-8447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 8, 2024 through May 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01075683A | IN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723420800000",
"number": "1487979563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 CUMBERLAND AVE STE C",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061304",
"telephone_number": "765-380-8447",
"fax_number": "765-356-9684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 CUMBERLAND AVE STE C",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479061304",
"telephone_number": "765-380-8447",
"fax_number": "765-356-9684"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIS",
"first_name": "DIANE",
"middle_name": "CROWLEY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-01",
"last_updated": "2024-08-12",
"certification_date": "2024-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01075683A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.