| Dr Dermot M Reynolds, MD | |
|
5301 W Genesee St, Camillus, NY 13031-2260 | |
| (607) 798-5971 | |
| (315) 833-9998 |
| Full Name | Dr Dermot M Reynolds |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 30 Years |
| Location | 5301 W Genesee St, Camillus, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487627139 | NPI | - | NPPES |
| P00120718 | Other | PA | RR MEDICARE PIN |
| 1487627139 | Medicaid | NY | |
| GU039978 | Other | PA | PA MEDICARE GROUP |
| 1008319990001 | Medicaid | PA | |
| 02521846 | Medicaid | NY | |
| CC9269 | Other | PA | RR MEDICARE GROUP |
| PA MEDICARE GROUP | Other | PA | GU039809 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | MD422314 (Pennsylvania) | Secondary |
| 207X00000X | Orthopaedic Surgery | 250206-01 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lourdes Hospital | Binghamton, NY | Hospital |
| Robert Packer Hospital | Sayre, PA | Hospital |
| Corning Hospital | Corning, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Our Lady Of Lourdes Memorial Hospital Inc | 1254237779 | 230 |
| Guthrie Medical Group Pc | 6002728656 | 725 |
| Entity Name | Guthrie Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134178635 PECOS PAC ID: 6002728656 Enrollment ID: O20031103000220 |
| Entity Name | Our Lady Of Lourdes Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629087580 PECOS PAC ID: 1254237779 Enrollment ID: O20031208000366 |
| Entity Name | St Josephs Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942501747 PECOS PAC ID: 4688855844 Enrollment ID: O20110221000744 |
| Entity Name | Southern Tier Medical Care - Ny Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134646276 PECOS PAC ID: 4981953106 Enrollment ID: O20180822000720 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Dermot M Reynolds, MD 5301 W Genesee St, Camillus, NY 13031-2260 Ph: (607) 798-5971 | Dr Dermot M Reynolds, MD 5301 W Genesee St, Camillus, NY 13031-2260 Ph: (607) 798-5971 |