Active NPI
Paul D Reynen, MD
- Orthopaedic Surgery Physician
- Worthington, MN
National Provider Identifier
1972589174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 35809
- Practice address
- 1680 Diagonal Rd
Worthington, MN 56187-1008 - Phone
- (507) 372-3800
- Fax
- (507) 372-3706
- NPI assigned
- Dec 20, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 35809 | MN | Primary |
Addresses
Primary practice location
1680 Diagonal Rd
Worthington, MN 56187-1008
Mailing address
1680 Diagonal Rd
Worthington, MN 56187-1008
Phone (507) 372-3800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6400662 | Medicaid | SD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | preynen10649@direct.sanfordhealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Institute PC | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 1
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": "1135036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1972589174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 DIAGONAL RD",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871008",
"telephone_number": "507-372-3800",
"fax_number": "507-372-3806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1680 DIAGONAL RD",
"city": "WORTHINGTON",
"state": "MN",
"postal_code": "561871008",
"telephone_number": "507-372-3800",
"fax_number": "507-372-3706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNEN",
"first_name": "PAUL",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-20",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "35809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6400662",
"state": "SD"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "preynen10649@direct.sanfordhealth.org",
"affiliation": "N",
"address_1": "1680 Diagonal Rd",
"city": "Worthington",
"state": "MN",
"country_code": "US",
"postal_code": "561871008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Worthington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.