Individual provider Active NPI

Nicholas Martinez Reyes, ATC

  • Athletic Trainer
  • New York, NY
National Provider Identifier
1124484498
Registry record updated Jan 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
002743-1 Issued in NY
Practice address
133 E 58TH St
15TH Floor
New York, NY 10022-1236
Phone
(212) 751-8300
NPI assigned
Jan 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 002743-1 NY Primary

Addresses

Primary practice location

133 E 58TH St
15TH Floor
New York, NY 10022-1236

Mailing address

133 E 58TH St
15TH Floor
New York, NY 10022-1236
Phone (212) 751-8300

Other identifiers 1

IdentifierTypeStateIssuer
1340673OtherNYPROFESSIONAL PROLIABILITY

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

State licenses

LicenseStateTypeSpecialty
002743-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1451692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451692800000",
    "number": "1124484498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "15TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-751-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E 58TH ST",
            "address_2": "15TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221236",
            "telephone_number": "212-751-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ REYES",
        "first_name": "NICHOLAS",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-02",
        "last_updated": "2016-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002743-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL PROLIABILITY",
            "identifier": "1340673",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.