Individual provider Active NPI

Erika Crystal Reyes, PA-C

  • Medical Physician Assistant
  • Corona, CA
National Provider Identifier
1043677859
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
53117 Issued in CA
Practice address
127 N McKinley St Ste 101
Corona, CA 92879-6563
Phone
(951) 278-2600
NPI assigned
Jan 25, 2016
Last updated
Jan 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 53117 CA Primary

Addresses

Primary practice location

127 N McKinley St Ste 101
Corona, CA 92879-6563

Mailing address

1027 Beverly Rd
Corona, CA 92879-2304
Phone (951) 833-5881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250908002632 CA Practitioner - Physician Assistant 6002189636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Western University of Health Sciences College of Dental Med, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7777 Milliken Ave
Suite 240
Rancho Cucamonga, CA 91730-6781

845 15TH St
Suite 103
San Diego, CA 92101-8098

PO Box
Suite 1855
San Ramon, CA 94583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: ereyes586776@direct.llu.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1043677859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 BEVERLY RD",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928792304",
            "telephone_number": "951-833-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N MCKINLEY ST STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928796563",
            "telephone_number": "951-278-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ERIKA",
        "middle_name": "CRYSTAL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.