Active NPI
Reid Waldman
- Student in an Organized Health Care Education/Training Program
- West Hollywood, CA
National Provider Identifier
1720514151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 8700 Beverly Blvd Ste 5512
West Hollywood, CA 90048-1804 - Phone
- (310) 423-5161
- NPI assigned
- May 4, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
8700 Beverly Blvd Ste 5512
West Hollywood, CA 90048-1804
Mailing address
8700 Beverly Blvd Ste 5512
West Hollywood, CA 90048-1804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210510000171 | CT | Practitioner - Dermatology | 7012266398 |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
210 New London Tpke
Glastonbury, CT 06033-2235
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 169 |
| Skin biopsy | 38 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1720514151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD STE 5512",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 BEVERLY BLVD STE 5512",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "900481804",
"telephone_number": "310-423-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDMAN",
"first_name": "REID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-04",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.