Individual provider Active NPI

Erik J Reiersen, M.D.

  • Anesthesiology Physician
  • West Islip, NY
National Provider Identifier
1740348531
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
213746-1 Issued in NY
Practice address
471 Montauk Hwy
West Islip, NY 11795-4414
Phone
(631) 849-1050
Fax
(631) 849-1052
NPI assigned
Dec 5, 2006
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 213746-1 NY Primary

Addresses

Primary practice location

471 Montauk Hwy
West Islip, NY 11795-4414

Mailing address

217 Cook St
Huntington Station, NY 11746-3503
Phone (516) 729-4108

Other identifiers 3

IdentifierTypeStateIssuer
ER03209N10OtherNYBLUE CROSS BLUE SHIELD
01962298MedicaidNY
213746-1 1WOtherNYWORKERS COMPENSATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20100629000675 NY Practitioner - Anesthesiology 2466583877 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213746-1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Star Suites LLC Anesthesiology CurrentSince Jan 10, 2023 Accepting new patients
Sri Gastroenterology PC CurrentSince Jan 1, 2014 Accepting new patients
Suffolk Anesthesia Services PLLC Anesthesiology CurrentSince Sep 20, 2013 Accepting new patients
Warren Lobo, MD, PC Anesthesiology Past Accepting new patients

Locations

623 Stewart Ave
Ste 101
Garden City, NY 11530
Phone (516) 222-7827

901 Stewart Ave
Ste 260
Garden City, NY 11530
Phone (516) 222-2727

471 Montauk Hwy
West Islip, NY 11795
Phone (631) 376-2260

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1740348531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 COOK ST",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117463503",
            "telephone_number": "516-729-4108",
            "fax_number": "631-849-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 MONTAUK HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954414",
            "telephone_number": "631-849-1050",
            "fax_number": "631-849-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIERSEN",
        "first_name": "ERIK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "213746-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "ER03209N10",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01962298",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "213746-1 1W",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

Verify at the official NPI Registry.