Reginald M Rousseau MD PC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

REGINALD M ROUSSEAU MD PC

Practice address

340 Howells Rd
Bay Shore, NY 11706-5322

Phone

(833) 547-7463

Fax

(631) 247-5583

NPI assigned

Mar 17, 2021

Organization subpart

No

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

Authorized official

Name

Reginald M Rousseau, MDNPI 1306822523

Title

Owner

Phone

(833) 547-7463

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Reginald Rousseau, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bay Shore, NY
  • NPI 1306822523
  Medicare reassignment NPD Authorized official
• Lisa Trentino, PA

  • Physician Assistant
  • West Islip, NY
  • NPI 1003385352
  Medicare reassignment NPD

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1568047967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MOTOR PARKWAY",
            "address_2": "SUITE LL8",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "11788",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 HOWELLS RD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065322",
            "telephone_number": "833-547-7463",
            "fax_number": "631-247-5583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Main St Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "NY",
            "postal_code": "117432847",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4681 Veterans Memorial Hwy",
            "address_purpose": "LOCATION",
            "city": "Holbrook",
            "state": "NY",
            "postal_code": "117414515",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Montauk Hwy",
            "address_purpose": "LOCATION",
            "city": "West Islip",
            "state": "NY",
            "postal_code": "117954927",
            "country_code": "US",
            "telephone_number": "833-547-7463",
            "fax_number": "631-248-5583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGINALD M ROUSSEAU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "ROUSSEAU",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-547-7463",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed Samar Raza, M.D.
• Joann Read, MS CCC-SLP
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• Erica A. Rega, OT
• Hafiz Ur Rehman, M.D. FAAP.
• Khalil U Rehman, MD
• Muzammil Rehman
• Rebecca Reich, MA CCC-SLP, TSSLD
• Reichman, Brown, Kaplan M.D.P.C (RBK Pediatrics Urgent Care)

• Interventional Pain Medicine Physician in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Interventional Pain Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.