Individual provider Active NPI

Reed G Panos, MD

  • Plastic and Reconstructive Surgery Physician
  • The Villages, FL
National Provider Identifier
1619987807
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
ME101860 Issued in FL
Practice address
1400 N US Highway 441
Ste 536
The Villages, FL 32159-8975
Phone
(352) 750-9879
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 036105811 IL
Plastic and Reconstructive Surgery Physician 2086S0122X ME101860 FL Primary

Addresses

Primary practice location

1400 N US Highway 441
Ste 536
The Villages, FL 32159-8975

Mailing address

PO Box 917770
Orlando, FL 32891-7770

Other identifiers 2

IdentifierTypeStateIssuer
240007584OtherILRAILROAD
0533210001OtherILDMERC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036105811ILMDPlastic and Reconstructive Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1619987807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441",
            "address_2": "STE 536",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598975",
            "telephone_number": "352-750-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "REED",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036105811",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "ME101860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "240007584",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0533210001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.