Active NPI
Stewart Perez Reyna, MD
- Pharmacist
- Baltimore, MD
National Provider Identifier
1043932874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16174
- Practice address
- 2504 N Charles St
Baltimore, MD 21218-4601 - Phone
- (410) 662-7594
- NPI assigned
- Sep 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 16174 | MD | Primary |
Addresses
Primary practice location
2504 N Charles St
Baltimore, MD 21218-4601
Mailing address
6221 Greenleigh Ave Unit 582
Middle River, MD 21220-2041
Phone (443) 306-4011
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16174 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maryland CVS Pharmacy, L.L.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Pharmacy
- Gaithersburg, MD
- NPI 1669100285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664064000000",
"number": "1043932874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6221 GREENLEIGH AVE UNIT 582",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202041",
"telephone_number": "443-306-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2504 N CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212184601",
"telephone_number": "410-662-7594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNA",
"first_name": "STEWART",
"middle_name": "PEREZ",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-19",
"last_updated": "2022-09-25",
"certification_date": "2022-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "16174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.