Individual provider Active NPI

Marina Reznik, MD

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1568532760
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
225339 Issued in NY
Practice address
MMC - Peds Emergency Medicine
111 East 210TH Street
Bronx, NY 10467
Phone
(718) 741-2150
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 225339 NY Primary

Addresses

Primary practice location

MMC - Peds Emergency Medicine
111 East 210TH Street
Bronx, NY 10467

Mailing address

71 Blauvelt Rd
Nanuet, NY 10954-3411
Phone (718) 741-2150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040402001082 NY Practitioner - Pediatric Medicine 0446242895 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225339NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Jan 1, 2019 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: mreznik@montefioredirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568532760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BLAUVELT RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109543411",
            "telephone_number": "718-741-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - PEDS EMERGENCY MEDICINE",
            "address_2": "111 EAST 210TH STREET",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-741-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNIK",
        "first_name": "MARINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "225339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.