Active NPI
Jahidah Reid, PHYSICIAN ASSISTANT
- Physician Assistant
- Fresh Meadows, NY
National Provider Identifier
1831397736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0111421
- Practice address
- 19705C 65TH Cres
Apt. 1C
Fresh Meadows, NY 11365-3965 - Phone
- (718) 264-2533
- NPI assigned
- Jul 3, 2007
- Last updated
- Oct 26, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0111421 | NY | Primary |
Addresses
Primary practice location
19705C 65TH Cres
Apt. 1C
Fresh Meadows, NY 11365-3965
Mailing address
19705C 65TH Cres
Apt. 1C
Fresh Meadows, NY 11365-3965
Phone (718) 264-2533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0111421 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256515200000",
"number": "1831397736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19705C 65TH CRES",
"address_2": "APT. 1C",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653965",
"telephone_number": "718-264-2533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19705C 65TH CRES",
"address_2": "APT. 1C",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113653965",
"telephone_number": "718-264-2533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "JAHIDAH",
"name_prefix": "Miss",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-03",
"last_updated": "2009-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "0111421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2009; 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.