Individual provider Active NPI

Andrew B Reese, MD

  • Family Medicine Physician
  • Waterloo, NY
National Provider Identifier
1861489312
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
211540-1 Issued in NY
Practice address
369 E Main St
Waterloo, NY 13165-1654
Phone
(315) 539-4025
Fax
(315) 539-4128
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 211540-1 NY Primary

Addresses

Primary practice location

369 E Main St
Waterloo, NY 13165-1654

Mailing address

369 E Main St
Waterloo, NY 13165-1654
Phone (315) 539-4025

Other identifiers 1

IdentifierTypeStateIssuer
02068702MedicaidNY

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
I20050912000319 NY Practitioner - Family Practice 9335172352 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211540-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
FLH Medical, PC CurrentSince Mar 1, 2012 Accepting new patients
FLH Medical, PC Family Medicine CurrentSince Mar 1, 2012 Accepting new patients
Soldiers & Sailors Memorial Hospital Current Accepting new patients
Soldiers & Sailors Memorial Hospital Past Accepting new patients

Locations

8000 Box
Buffalo, NY 14267
Phone (716) 213-0772

141 Central Ave
Keuka Park, NY 14478
Phone (315) 279-5000

1991 Balsley Rd
Seneca Falls, NY 13148
Phone (315) 539-0237

28 Cayuga St
Seneca Falls, NY 13148
Phone (315) 568-4415

1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488

369 E Main St
Waterloo, NY 13165
Phone (315) 539-4025

Interoperability endpoints

  • Direct secure messaging: a.reese@flhmedical.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1861489312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651654",
            "telephone_number": "315-539-4025",
            "fax_number": "315-539-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 E MAIN ST",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651654",
            "telephone_number": "315-539-4025",
            "fax_number": "315-539-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "ANDREW",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "211540-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02068702",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, NY

Sources for this page

Verify at the official NPI Registry.