Individual provider Active NPI

Armando Jesus Reyes, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1053960955
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031878 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 851-2888
NPI assigned
Sep 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 031878 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

615 W 131St St FL 4
New York, NY 10027-7984
Phone (212) 851-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210312001603 WA Practitioner - Physician Assistant 6608282876 Reassigns benefits to 1 organization
I20240627002238 NY Practitioner - Physician Assistant 6608282876 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031878NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince May 21, 2024 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince May 21, 2024 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Apr 16, 2021 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Apr 16, 2021 Accepting new patients

Locations

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
#260
New York, NY 10032
Phone (212) 305-2330

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1053960955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W 131ST ST FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100277984",
            "telephone_number": "212-851-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-851-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ARMANDO",
        "middle_name": "JESUS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-04",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.