Individual provider Active NPI

Donald J. Reese, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Nanticoke, PA
National Provider Identifier
1497872816
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
SC-002772 L Issued in PA
Practice address
28 W Broad St
Nanticoke, PA 18634-2203
Phone
(570) 735-1100
Fax
(570) 740-1386
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X SC-002772 L PA Primary

Addresses

Primary practice location

28 W Broad St
Nanticoke, PA 18634-2203

Mailing address

28 W Broad St
Nanticoke, PA 18634-2203
Phone (570) 735-1100

Other identifiers 1

IdentifierTypeStateIssuer
1213309MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071023000752 PA Practitioner - Podiatry 3577659432 Practice locations: Nanticoke, PA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

28 W Broad St
Nanticoke, PA 18634-2203
Phone (570) 735-1100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue320
Removal or shaving of skin growth246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
SC-002772 LPAMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269388800000",
    "number": "1497872816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 W BROAD ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342203",
            "telephone_number": "570-735-1100",
            "fax_number": "570-740-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W BROAD ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342203",
            "telephone_number": "570-735-1100",
            "fax_number": "570-740-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "DONALD",
        "middle_name": "J.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2010-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC-002772 L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1213309",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanticoke, PA

Sources for this page

Verify at the official NPI Registry.