Active NPI
Donald J. Reese, D.P.M.
- Primary Podiatric Medicine Podiatrist
- Nanticoke, PA
National Provider Identifier
1497872816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- SC-002772 L
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1213309 | Medicaid | PA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 320 |
| Removal or shaving of skin growth | 246 |
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC-002772 L | PA | MD | Primary 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2010; 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.