Individual provider Active NPI

Johanna Ariel Blythe Reske, MD

  • Psychiatry Physician
  • Louisville, KY
National Provider Identifier
1750948931
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
58631 Issued in KY
Practice address
10510 La Grange Rd
Louisville, KY 40223-1228
Phone
(502) 253-7623
NPI assigned
May 23, 2019
Last updated
Jan 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 325547 NY
Psychiatry Physician 2084P0800X 58631 KY Primary

Addresses

Primary practice location

10510 La Grange Rd
Louisville, KY 40223-1228

Mailing address

739 E Madison St
Louisville, KY 40202-3612
Phone (859) 496-7426

Other practice location 1

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-3000

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
I20240208000621 NY Practitioner - Psychiatry 2769888247 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58631KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Affiliate Group of New York PC CurrentSince Aug 1, 2024 Accepting new patients
University of Rochester Department of Psychiatry Clinical Group Psychiatry CurrentSince Mar 31, 2024 Accepting new patients
University of Rochester CurrentSince Mar 31, 2024 Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Dec 13, 2023 Accepting new patients
University of Rochester Current Accepting new patients
University of Rochester CurrentSince Mar 31, 2024 Accepting new patients

Locations

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jblythereske3642884@nychhc.direct-ci.com
  • Direct secure messaging: jblythereske491446@direct.urmc.rochester.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1750948931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 E MADISON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023612",
            "telephone_number": "859-496-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402231228",
            "telephone_number": "502-253-7623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021675",
            "country_code": "US",
            "telephone_number": "502-562-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLYTHE RESKE",
        "first_name": "JOHANNA",
        "middle_name": "ARIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325547",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "58631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.