Individual provider Active NPI

Reshmi Kapoor

  • Dermatology Physician
  • New Hyde Park, NY
National Provider Identifier
1881058634
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
305035 Issued in NY
Practice address
1991 Marcus Ave Ste 300
New Hyde Park, NY 11042-2058
Phone
(516) 719-3376
Fax
(646) 962-0040
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 305035 NY Primary

Addresses

Primary practice location

1991 Marcus Ave Ste 300
New Hyde Park, NY 11042-2058

Mailing address

1991 Marcus Ave Ste 300
New Hyde Park, NY 11042-2058
Phone (516) 719-3376

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Sep 27, 2022 through Sep 27, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
305305NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1881058634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE STE 300",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422058",
            "telephone_number": "516-719-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE STE 300",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422058",
            "telephone_number": "516-719-3376",
            "fax_number": "646-962-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPOOR",
        "first_name": "RESHMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "305035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.