Organization Active NPI

Santiago Reyes, M.D., Inc

  • Medical Specialty Clinic/Center
  • Oklahoma City, OK
National Provider Identifier
1073793741
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
11652 Issued in OK
Legal business name
SANTIAGO REYES, M.D., INC
Practice address
3366 NW Expressway
Suite 330
Oklahoma City, OK 73112-4462
Phone
(405) 945-4495
Fax
(405) 945-4376
NPI assigned
Nov 9, 2007
Last updated
Apr 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Dr. Santiago Reyes, MDNPI 1497770911
Title
President
Phone
(405) 945-4495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 11652 OK Primary

Addresses

Primary practice location

3366 NW Expressway
Suite 330
Oklahoma City, OK 73112-4462

Mailing address

3366 NW Expressway
Suite 330
Oklahoma City, OK 73112-4462
Phone (405) 945-4495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120928000293 OK Part B Supplier - Clinic/Group Practice 1153570551 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1073793741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY",
            "address_2": "SUITE 330",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-945-4495",
            "fax_number": "405-945-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 NW EXPRESSWAY",
            "address_2": "SUITE 330",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-945-4495",
            "fax_number": "405-945-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAGO REYES, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "SANTIAGO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-945-4495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "11652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.