Individual provider Active NPI

Andrew Maynard-Reid, MSPT

  • Physical Therapist
  • Rego Park, NY
National Provider Identifier
1972658813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
022605-1 Issued in NY
Practice address
6284 Woodhaven Blvd
Rego Park, NY 11374-3738
Phone
(718) 424-9531
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
Yes

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
Physical Therapist 225100000X 022605-1 NY Primary

Addresses

Primary practice location

6284 Woodhaven Blvd
Rego Park, NY 11374-3738

Mailing address

6284 Woodhaven Blvd
Rego Park, NY 11374-3738
Phone (718) 424-9531

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071115000290 NY Practitioner - Physical Therapist in Private Practice 5395833164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255

9616 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone (718) 424-9531

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
022605-1NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Montefiore Medical Center CurrentSince Jul 1, 2021 Accepting new patients
Madison Avenue Physical Therapy, PC Physical Therapist Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

9614 Metropolitan Ave
Ste B
Forest Hills, NY 11375
Phone (718) 424-9531

9616 Metropolitan Ave
Forest Hills, NY 11375

7215 Grand Ave
Maspeth, NY 11378
Phone (718) 803-2058

Networks

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

Organizations & group practices 3

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972658813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6284 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743738",
            "telephone_number": "718-424-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6284 WOODHAVEN BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743738",
            "telephone_number": "718-424-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD-REID",
        "first_name": "ANDREW",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022605-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.