Individual provider Active NPI

Jason Benjamin Reina, MD

  • Specialist
  • Hammond, LA
National Provider Identifier
1548236391
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD025097 Issued in LA
Practice address
16061 Doctors Blvd
Suite B
Hammond, LA 70403-1479
Phone
(504) 338-4746
Fax
(985) 318-1005
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD025097 LA Primary

Addresses

Primary practice location

16061 Doctors Blvd
Suite B
Hammond, LA 70403-1479

Mailing address

16061 Doctors Blvd
Suite B
Hammond, LA 70403-1479
Phone (504) 338-4746

Other identifiers 1

IdentifierTypeStateIssuer
1576441MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20060316000180 LA Practitioner - Gastroenterology 1951318955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Louisiana State University School of Medicine in New Orleans, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northlake GastroenterologyGroup PAC ID 9234197419, 9 clinicians

Practice addresses (Care Compare)

16061 Doctors Blvd
Suite B
Hammond, LA 70403-1499
Phone (985) 542-1334

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.58 of 100Reported as group
Quality
72.72
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy147
Upper gastrointestinal (GI) endoscopy for acid reflux235

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD025097LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northlake Gastroenterology Specialist CurrentSince Jul 1, 2006 Accepting new patients
Northlake Endoscopy, LLC PastSince Jun 1, 2006 Accepting new patients

Locations

7015 Highway 190 East Service Rd
Ste 102
Covington, LA 70433
Phone (985) 542-1334

16061 Doctors Blvd
Ste A
Hammond, LA 70403
Phone (985) 345-6090

16061 Doctors Blvd
Ste B
Hammond, LA 70403
Phone (985) 542-1334

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586217600000",
    "number": "1548236391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16061 DOCTORS BLVD",
            "address_2": "SUITE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031479",
            "telephone_number": "504-338-4746",
            "fax_number": "985-318-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16061 DOCTORS BLVD",
            "address_2": "SUITE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031479",
            "telephone_number": "504-338-4746",
            "fax_number": "985-318-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINA",
        "first_name": "JASON",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MD025097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1576441",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.