NPIMap

Organization Active NPI

Reis Pediatrics LLC

  • Pediatrics Physician
  • Kailua, HI
National Provider Identifier
1902196314
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
REIS PEDIATRICS LLC
Practice address
30 Aulike St
Suite 500
Kailua, HI 96734-2739
Phone
(808) 263-8822
Fax
(808) 261-6749
NPI assigned
Apr 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Brijiit Reis, MD
Title
Owner
Phone
(808) 263-8822

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0200X

Addresses

Primary practice location

30 Aulike St
Suite 500
Kailua, HI 96734-2739

Mailing address

30 Aulike St
Suite 500
Kailua, HI 96734-2739
Phone (808) 263-8822

Other identifiers 2

IdentifierTypeStateIssuer
526400MedicaidHI
50832701MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191003000367 HI Part B Supplier - Clinic/Group Practice 0042108029 Receives reassigned benefits from 7 practitioners
Practice locations: Kailua, HI; Kaneohe, HI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D0619163Reis Pediatrics LLC30 Aulike St, Suite 500, Kailua, HI 96734Certificate of waiverMay 1, 2027

National Provider Directory

National Provider Directory

Locations

81833 Doctor Carreon Blvd
Ste 2
Indio, CA 92201
Phone (760) 863-0155

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1902196314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AULIKE ST",
            "address_2": "SUITE 500",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342739",
            "telephone_number": "808-263-8822",
            "fax_number": "808-261-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 AULIKE ST",
            "address_2": "SUITE 500",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342739",
            "telephone_number": "808-263-8822",
            "fax_number": "808-261-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIS PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "REIS",
        "authorized_official_first_name": "BRIJIIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-263-8822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "526400",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50832701",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.