Individual provider Active NPI

Reeli Reinu, PA

  • Physician Assistant
  • Maitland, FL
National Provider Identifier
1609884253
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102028 Issued in FL
Practice address
2600 Lake Lucien Dr Ste 180
Maitland, FL 32751-7235
Phone
(407) 875-2080
Fax
(407) 875-0518
NPI assigned
Aug 3, 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
Physician Assistant 363A00000X PA9102028 FL Primary

Addresses

Primary practice location

2600 Lake Lucien Dr Ste 180
Maitland, FL 32751-7235

Mailing address

1768 Park Center Dr Ste 300
Orlando, FL 32835-6256
Phone (407) 445-9445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061206000324 FL Practitioner - Physician Assistant 5294734976 Reassigns benefits to 1 organization
I20240130002989 SC Practitioner - Physician Assistant 5294734976 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of SC PCGroup PAC ID 4284864372, 32 clinicians

Practice addresses (Care Compare)

1650 Skylyn Dr
Suite 402
Spartanburg, SC 29307-1086
Phone (864) 574-0017

26 Roper Corners Cir
Greenville, SC 29615-4833
Phone (864) 234-7744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102028FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 1, 2006 Accepting new patients
Leavitt Medical Associates of Florida Inc CurrentSince Aug 1, 2006 Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

2600 Lucien Dr
Ste 180
Maitland, FL 32751

1768 Park Center Dr
Ste 300
Orlando, FL 32835
Phone (407) 445-9445

1410 W Broadway St
Ste 205
Oviedo, FL 32765
Phone (407) 359-2100

1503 Buenos Aires Blvd
Ste 100
The Villages, FL 32159
Phone (352) 753-2812

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609884253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 PARK CENTER DR STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356256",
            "telephone_number": "407-445-9445",
            "fax_number": "407-293-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LAKE LUCIEN DR STE 180",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517235",
            "telephone_number": "407-875-2080",
            "fax_number": "407-875-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINU",
        "first_name": "REELI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.