Kevin J Reagan, M.D.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

036021 Issued in CT

Practice address

35 Kennedy Dr
Putnam, CT 06260-1939

Phone

(860) 963-2133

Fax

(860) 963-8955

NPI assigned

Jun 30, 2005

Last updated

May 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Orthopedic Associates of Windham County LLP

  dba The Center For Bone & Joint Care

  • Orthopaedic Surgery Physician
  • Putnam, CT
  • NPI 1770532566
  NPD

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1730186222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 KENNEDY DR",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601939",
            "telephone_number": "860-963-2133",
            "fax_number": "860-963-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 KENNEDY DR",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601939",
            "telephone_number": "860-963-2133",
            "fax_number": "860-963-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "KEVIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CT",
            "license": "036021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001360213",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quiet Corner Psychiatry, PLLC
• Merinessa Macayaon Quintilla, PT
• Ana L Ramos
• Kristy L Ranucci
• Alex Joseph Rarey, APRN
• Lisa M Reardon, LCSW
• Reflective Counseling, LLC
• Laura Richard
• Cynthia Lunt Richardson, OTR
• Alessia Ritacco, NP

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Putnam, CT
• Providers in Putnam, CT by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.