ROBERT REYNOLDS PA NPI 1760463483

NPI Information

NPI: 1760463483
Provider Name: ROBERT REYNOLDS, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1 TITUS PL
WALTON, NY
ZIP 13856
Phone: (607) 865-2100
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Robert Reynolds, PA is a medical physician assistant in Walton, NY. Robert Reynolds, PA NPI is 1760463483. 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:

1 TITUS PL
WALTON, NY
ZIP 13856-457
Phone: (607) 865-2100
Fax: (607) 785-2584

The NPI 1760463483 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 11/9/2005 and was last updated on 12/15/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		008363	NEW YORK	No
2	363AM0700X	Physician Assistant	Medical	008363	NEW YORK	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	J400005668	MEDICARE PIN	NEW YORK
2	P46018	MEDICARE UPIN
3	CC9862	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK

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: 11/14/2023

NPI Synchronization or Removal

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