Individual provider Active NPI

Michael F Reidy, MD

  • Pulmonary Disease Physician
  • Flagstaff, AZ
National Provider Identifier
1609950500
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
36111 Issued in AZ
Practice address
1215 N Beaver St
Flagstaff, AZ 86001-3120
Phone
(928) 773-2200
Fax
(928) 773-2300
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MEDPHYSCOMLIC112031 MT
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 19443 NV
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 36111 AZ
Critical Care Medicine (Internal Medicine) Physician 207RC0200X M-11933 ID
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD165581 OR
Pulmonary Disease Physician 207RP1001X 36811 NC
Pulmonary Disease Physician 207RP1001X 19443 NV
Pulmonary Disease Physician 207RP1001X 36111 AZ Primary

Addresses

Primary practice location

1215 N Beaver St
Flagstaff, AZ 86001-3120

Mailing address

PO Box 967
Flagstaff, AZ 86002-0967
Phone (928) 773-0003

Other practice location 1

1155 Mill St
Reno, NV 89502-1576
Phone (775) 982-7878

Other practice location 2

350 Heritage Way Ste 2100
Kalispell, MT 59901-3167
Phone (406) 257-8992

Other practice location 3

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 302-2055

Other identifiers 1

IdentifierTypeStateIssuer
158034MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address DEPTLHRevIntegrityHIMTechs@logan.org Kalispell Regional Medical Center Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140528001482 AZ Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1557363223 Reassigns benefits to 1 organization
I20150926000188 NM Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Pulmonary Disease 1557363223

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
George Washington University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-6025

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36111AZMDCritical Care Medicine (Internal Medicine) Physician
MEDPHYSCOMLIC112031MTMDCritical Care Medicine (Internal Medicine) Physician
36811NCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pathology Associates Current Accepting new patients
Northern Arizona Healthcare Corporation Internal Medicine CurrentSince Dec 10, 2023 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Dec 10, 2023 Accepting new patients
Flagstaff Intensive Care Specialists, PLLC Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients
Dignity Health Past Accepting new patients
St Vincent Hospital Past Accepting new patients
Dignity Health Past Accepting new patients
Flagstaff Medical Center Past Accepting new patients
Flagstaff Medical Center Past Accepting new patients
Dakota Specialty Institute Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients

Locations

199 S Candy Ln
Ste 1A
Cottonwood, AZ 86326
Phone (602) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Flagstaff, AZ 86001
Phone (928) 773-2200

Interoperability endpoints

  • Direct secure messaging: mreidy155273@direct.renown.org

Organizations & group practices 12

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 6

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1609950500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860020967",
            "telephone_number": "928-773-0003",
            "fax_number": "928-773-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013120",
            "telephone_number": "928-773-2200",
            "fax_number": "928-773-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Mill St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895021576",
            "country_code": "US",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Heritage Way Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Kalispell",
            "state": "MT",
            "postal_code": "599013167",
            "country_code": "US",
            "telephone_number": "406-257-8992",
            "fax_number": "406-257-8996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-302-2055",
            "fax_number": "208-302-2055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIDY",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MT",
            "license": "MEDPHYSCOMLIC112031",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NV",
            "license": "19443",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "AZ",
            "license": "36111",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "ID",
            "license": "M-11933",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OR",
            "license": "MD165581",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "36811",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NV",
            "license": "19443",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AZ",
            "license": "36111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158034",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "DEPTLHRevIntegrityHIMTechs@logan.org",
            "affiliation": "Y",
            "affiliationName": "Kalispell Regional Medical Center Inc",
            "address_1": "350 Heritage Way Ste 2100",
            "city": "Kalispell",
            "state": "MT",
            "country_code": "US",
            "postal_code": "599013167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.