Active NPI
Mark J Reger, MD
- Cardiovascular Disease Physician
- Liverpool, NY
National Provider Identifier
1649266818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 145191
- Practice address
- 4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800 - Phone
- (315) 448-6215
- NPI assigned
- Sep 23, 2005
- Last updated
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 145191 | NY | Primary |
| Interventional Cardiology Physician | 207RI0011X | 145191 | NY |
Addresses
Primary practice location
4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800
Mailing address
4820 W Taft Rd
Suite 209
Liverpool, NY 13088-2800
Phone (315) 448-6215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00716981 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 145191 | NY | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates for Women's Medicine PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222905600000",
"number": "1649266818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4820 W TAFT RD",
"address_2": "SUITE 209",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130882800",
"telephone_number": "315-448-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4820 W TAFT RD",
"address_2": "SUITE 209",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130882800",
"telephone_number": "315-448-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGER",
"first_name": "MARK",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2008-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "145191",
"primary": true
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "NY",
"license": "145191",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00716981",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.