Individual provider Active NPI

Stanley Y Reddy, M.D.

  • Psychiatry Physician
  • Long Beach, NY
National Provider Identifier
1952474496
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
129678-1 Issued in NY
Practice address
871 E Park Ave
Long Beach, NY 11561-2709
Phone
(516) 889-8844
Fax
(516) 889-8857
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 129678-1 NY Primary

Addresses

Primary practice location

871 E Park Ave
Long Beach, NY 11561-2709

Mailing address

871 E Park Ave
Long Beach, NY 11561-2709
Phone (516) 889-8844

Other identifiers 1

IdentifierTypeStateIssuer
00478299MedicaidNY

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
I20041101000240 NY Practitioner - Psychiatry 8921060161 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Long Island Psychiatric Associates PCGroup PAC ID 6709776099, 2 clinicians

Practice addresses (Care Compare)

871 E Park Ave
Long Beach, NY 11561-2709
Phone (516) 510-3205

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
129678-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Horizon Counseling Center Inc CurrentSince Jan 1, 2015 Accepting new patients
Inner Calm Corp Psychiatry Past Accepting new patients
Diabetes & Endocrine of Long Beach P.C. PastSince Apr 22, 2021 Accepting new patients

Locations

10819 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 327-7202

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952474496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612709",
            "telephone_number": "516-889-8844",
            "fax_number": "516-889-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 E PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115612709",
            "telephone_number": "516-889-8844",
            "fax_number": "516-889-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDY",
        "first_name": "STANLEY",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "129678-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00478299",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.