Individual provider Active NPI

Bruce Walter Reid, M.D.

  • Orthopaedic Surgery Physician
  • Hampton, VA
National Provider Identifier
1780677930
Registry record updated Aug 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101036538 Issued in VA
Practice address
304 Marcella Rd
Suite B
Hampton, VA 23666-2578
Phone
(757) 864-0840
Fax
(757) 864-0848
NPI assigned
Aug 23, 2005
Last updated
Aug 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 0101036538 VA Primary

Addresses

Primary practice location

304 Marcella Rd
Suite B
Hampton, VA 23666-2578

Mailing address

304 Marcella Rd
Suite B
Hampton, VA 23666-2578
Phone (757) 864-0840

Other identifiers 1

IdentifierTypeStateIssuer
1780677930MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20070830000501 VA Practitioner - Orthopedic Surgery 0446343867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Howard University College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

304 Marcella Rd
Suite B
Hampton, VA 23666-2578
Phone (757) 864-0840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Orthopaedic Group, PC Orthopaedic Surgery CurrentSince May 10, 2010 Accepting new patients
Peninsula Orthopaedic Group, PC Orthopaedic Surgery Current Accepting new patients

Locations

304 Marcella Rd
Ste B
Hampton, VA 23666
Phone (757) 864-0840

Interoperability endpoints

  • Direct secure messaging: bruce.reid.1@6016.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/6016/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377302400000",
    "number": "1780677930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "address_2": "SUITE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-864-0840",
            "fax_number": "757-864-0848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MARCELLA RD",
            "address_2": "SUITE B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662578",
            "telephone_number": "757-864-0840",
            "fax_number": "757-864-0848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "BRUCE",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2013-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101036538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780677930",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.