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Jay Brian Reynolds

Anesthesiology

Allopathic & Osteopathic Physicians

601 W 5th Ave, Suite 500, Spokane, WA 99204-2756

PECOS Enrollment

This provider is enrolled in PECOS as JAY REYNOLDS.

Based on the most recent information from CMS, provider Jay Brian Reynolds is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1922075647
Provider Type
Individual
Full Name
Reynolds, Jay Brian
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
3/1/2006
Last Updated
3/11/2008

Contact Information

Practice Location

601 W 5th Ave, Suite 500, Spokane, WA 99204-2756

(509) 344-2663

(509) 624-9179

Mailing Location

601 W 5th Ave, Suite 400, Spokane, WA 99204-2715

(509) 344-2663

(509) 624-9179

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License MD00018611 Washington

Provider Identifiers

ID	Description	Issuer
ID 000010146345	Description Other	Issuer REGENCE BLUE SHIELD OF ID Idaho
ID 50594	Description Other	Issuer DEPT OF LABOR & INDUSTRIE Washington
ID 8938899	Description Other	Issuer CRIME VICTIMS Washington
ID 0082229	Description Medicaid	Issuer Unlisted Montana
ID 5870RE	Description Other	Issuer ASURIS NW HEALTH Washington
ID KV510	Description Other	Issuer BLUE CROSS OF IDAHO Idaho
ID P00092594	Description Other	Issuer RR MEDICARE Washington
ID 1073451	Description Medicaid	Issuer Unlisted Washington
ID G8801891	Description Other	Issuer MEDICARE ID
ID 930	Description Other	Issuer GROUP HEALTH NW Washington

Jay Brian Reynolds

PECOS Enrollment

Profile Details

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