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DR. JONATHAN ROBERT REIDEL MD NPI 1184793481


NPI Information

NPI: 1184793481
Provider Name: DR. JONATHAN ROBERT REIDEL, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
375 WILLARD AVE
GROVE HILL MEDICAL CENTER
NEWINGTON, CT
ZIP 06111
Phone: (860) 666-5167
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DR. Jonathan Robert Reidel, MD is a pediatrics in Newington, CT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Jonathan Robert Reidel, MD NPI is 1184793481. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

375 WILLARD AVE
GROVE HILL MEDICAL CENTER
NEWINGTON, CT
ZIP 06111-300
Phone: (860) 666-5167
Fax: (860) 665-8168

The NPI 1184793481 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 4/1/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics044890CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1370001687MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTMEDICARE
2010044890CT01OTHERCONNECTICUTBCBS & BCFP PROV ID
3369523OTHERCONNECTICUTWELLCARE MEDICARE
47615732OTHERCONNECTICUTCIGNA
5P3735238OTHERCONNECTICUTOXFORD
6C01373MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTGHMC GROUP CARE ID
7001448902MEDICAIDCONNECTICUT
81470175OTHERCONNECTICUTAETNA
9I64740MEDICARE UPINCONNECTICUT
10227660OTHERCONNECTICUTCONNECTICARE
112V8732OTHERCONNECTICUTHEALTH NET
12004195930MEDICAIDCONNECTICUT
131255448155OTHERCONNECTICUTGHMC GROUP NPI ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.