Individual provider Active NPI

Alexander Reid, MD

  • MOHS-Micrographic Surgery Physician
  • Danville, PA
National Provider Identifier
1649775461
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD478705 Issued in PA
Practice address
16 Woodbine LN
Danville, PA 17822-1009
Phone
(570) 271-8050
Fax
(570) 271-5940
NPI assigned
Mar 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
MOHS-Micrographic Surgery Physician 207ND0101X MD478705 PA Primary
Dermatology Physician 207N00000X R-11424 IA

Addresses

Primary practice location

16 Woodbine LN
Danville, PA 17822-1009

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other practice location 1

1673 Gezon Pkwy SW Ste A
Wyoming, MI 49519-9520
Phone (616) 243-3376 ext. 101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MI, SD3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20221018003182 PA Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - Dermatology 4880942861 Reassigns benefits to 1 organization
I20230821002214 MI Practitioner - Dermatology 4880942861 Reassigns benefits to 1 organization
I20260612002394 SD Practitioner - Dermatology 4880942861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Michigan Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

120 E Michigan St
Spearfish, SD 57783-1506
Phone (605) 791-7788

216 Anamaria Dr
Rapid City, SD 57701-7366
Phone (605) 791-7777

3024 Tower Rd
Rapid City, SD 57701-5392
Phone (605) 508-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision46
Removal of skin lesions22
Removal of skin cancer149
Removal or shaving of skin growth1-10
Skin biopsy24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-11424IAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Oct 3, 2022 Accepting new patients
Wolverine Dermatology, PC Dermatology CurrentSince Aug 1, 2023 Accepting new patients

Locations

1673 Gezon Pkwy SW
Wyoming, MI 49519
Phone (616) 243-3376

1673 Gezon Pkwy SW
Ste A
Wyoming, MI 49519
Phone (616) 243-3376

16 Woodbine Ln
Danville, PA 17821
Phone (570) 271-6531

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00325

Organizations & group practices 4

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": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1649775461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WOODBINE LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178221009",
            "telephone_number": "570-271-8050",
            "fax_number": "570-271-5940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1673 Gezon Pkwy SW Ste A",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199520",
            "country_code": "US",
            "telephone_number": "616-243-3376 x101",
            "fax_number": "616-243-3377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "PA",
            "license": "MD478705",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "R-11424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.