Active NPI
Ma Cristina V De Los Reyes, PT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1164556445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 36451
- Practice address
- 6041 Cadillac Ave
Los Angeles, CA 90034-1702 - Phone
- (323) 857-2020
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 05009159A | IN | |
| Physical Therapist | 225100000X | 36451 | CA | Primary |
Addresses
Primary practice location
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Mailing address
5980 W 71St St
Suite 201
Indianapolis, IN 46278-2711
Phone (317) 388-0800
Other names 1
- Cristina V De Los Reyes
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05009159A | IN | MD | Contractor |
| 36451 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Therapies at Home | 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.
-
- Non-Pharmacy Dispensing Site
- Indianapolis, IN
- NPI 1255364758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640563200000",
"number": "1164556445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5980 W 71ST ST",
"address_2": "SUITE 201",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462782711",
"telephone_number": "317-388-0800",
"fax_number": "317-388-0805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6041 CADILLAC AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900341702",
"telephone_number": "323-857-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LOS REYES",
"first_name": "MA CRISTINA",
"middle_name": "V",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2021-12-27",
"certification_date": "2021-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "IN",
"license": "05009159A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "36451",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6041 Cadillac Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900341702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CRISTINA",
"last_name": "DE LOS REYES",
"middle_name": "V",
"credential": "PT",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Los Angeles, CA
- Amanda Emma De Loera-Morales, LCSW
- De Longpre Medical Center Inc
- De Longpre Medical Center Inc
- De Los Dos: a Licensed Clinical Social Worker Corporation
- Iris K De Los Reyes, L.C.S.W.
- Isabel De Los Rios
- Erwin Jesus De Los Santos Gervacio
- Austin De Los Santos, DDS
- Emily Nicole De Los Santos
- Irene De Los Santos, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.