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
- Last updated
- Sep 25, 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, 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": "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.