Individual provider Active NPI

Brent Reitz, LSW

  • Social Worker
  • Medina, OH
National Provider Identifier
1821662511
Registry record updated Feb 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1802839 Issued in OH
Practice address
1065 Medina Rd
Medina, OH 44256-5375
Phone
(216) 220-9844
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1802839 OH Primary

Addresses

Primary practice location

1065 Medina Rd
Medina, OH 44256-5375

Mailing address

1065 Medina Rd
Medina, OH 44256-5375
Phone (216) 220-9844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1802839OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McIntyre Center Inc. PastSince May 1, 2021 Accepting new patients
Boundless Health, Inc. PastSince Feb 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brent.reitz.p1@direct.iamboundless.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1821662511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 MEDINA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565375",
            "telephone_number": "216-220-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 MEDINA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565375",
            "telephone_number": "216-220-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZ",
        "first_name": "BRENT",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1802839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.