Individual provider Active NPI

Antonio Reyes, MD

  • Urology Physician
  • Pembroke Pines, FL
National Provider Identifier
1174584809
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME70206 Issued in FL
Practice address
600 N Hiatus Rd
Suite 209
Pembroke Pines, FL 33026-5207
Phone
(954) 965-9860
Fax
(954) 965-9870
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME70206 FL Primary

Addresses

Primary practice location

600 N Hiatus Rd
Suite 209
Pembroke Pines, FL 33026-5207

Mailing address

2160 Colonial Blvd
Attn: Payer Contracting & Relations
Fort Myers, FL 33907-1410
Phone (239) 931-7342

Other identifiers 16

IdentifierTypeStateIssuer
2227616OtherFLAETNA
59436OtherFLHEALTH SUN
P01709685OtherFLSIMPLY HEALTHCARE
237204OtherFLAVMED
PRV0002461OtherFLPREFERRED MEDICAL PLAN
033303OtherFLNHP
8837OtherFLDIMENSION HEALTH
46607OtherFLBLUE CROSS BLUE SHIELD
5699441OtherFLAETNA
P01041697OtherFLRAILROAD MCR
24164OtherFLMEDICA
P942521OtherFLOPTIMUM
P1001893OtherFLFREEDOM HEALTH
QMP000003674076OtherFLMOLINA
256864100MedicaidFL
F00201863802OtherFLUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000218 FL Practitioner - Urology 6305851627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesiscare USA of Florida LLCGroup PAC ID 9830082882, 172 clinicians

Practice addresses (Care Compare)

1419 SE 8TH Ter
Cape Coral, FL 33990-3213
Phone (239) 772-3202

600 N Hiatus Rd
Suite 209
Pembroke Pines, FL 33026-5207
Phone (954) 965-9860

Hospital & facility affiliations

  • Memorial Hospital Pembroke Hospital, Pembroke Pines, FL, CCN 100230
  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Hospital Miramar Hospital, Miramar, FL, CCN 100285
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME70206FLMDUrology Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
21St Century Oncology LLC Urology CurrentSince Apr 2, 2012 Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Apr 2, 2012 Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Jun 25, 2023 Accepting new patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Genesiscare USA of Florida LLC Urology Past Accepting new patients
Steven L Morganstern Urology Clinic PastSince Oct 28, 2017 Accepting new patients

Locations

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

2160 Colonial Blvd
Fort Myers, FL 33907

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

600 N Hiatus Rd
Ste 209
Pembroke Pines, FL 33026
Phone (954) 965-9860

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: antonioreyes@vanuro.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1174584809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071410",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HIATUS RD",
            "address_2": "SUITE 209",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265207",
            "telephone_number": "954-965-9860",
            "fax_number": "954-965-9870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME70206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2227616",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SUN",
            "identifier": "59436",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIMPLY HEALTHCARE",
            "identifier": "P01709685",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "237204",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICAL PLAN",
            "identifier": "PRV0002461",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "033303",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION HEALTH",
            "identifier": "8837",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "46607",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5699441",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01041697",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "24164",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P942521",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P1001893",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMP000003674076",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256864100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "F00201863802",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.