NPIMap

Individual provider Active NPI

Justin Charles Reis, M.D.

  • Pulmonary Disease Physician
  • Pensacola, FL
National Provider Identifier
1184851073
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25967 Issued in NE
Practice address
4700 Bayou Blvd Ste 6
Pensacola, FL 32503-1901
Phone
(850) 477-9253
Fax
(850) 494-9843
NPI assigned
Jun 17, 2009
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 25967 NE
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 25967 NE
Pulmonary Disease Physician 207RP1001X 25967 NE Primary

Addresses

Primary practice location

4700 Bayou Blvd Ste 6
Pensacola, FL 32503-1901

Mailing address

4700 Bayou Blvd Ste 6
Pensacola, FL 32503-1901
Phone (850) 477-9253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730000613 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2264679075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Saint Louis University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pensacola Lung Group, M.D.'S, P.a.Group PAC ID 7517928062, 31 clinicians

Practice addresses (Care Compare)

4700 Bayou Blvd
Suite 6
Pensacola, FL 32503-1901
Phone (850) 477-9253

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25967NEMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Lung Group, M.D.'S, P.a. CurrentSince Jul 1, 2020 Accepting new patients
Texas Ips LLC Critical Care Medicine CurrentSince Jan 4, 2019 Accepting new patients

Locations

4700 Bayou Blvd
Ste 6
Pensacola, FL 32503
Phone 8504779253 ext. 4616

225 E Sonterra Blvd
Ste 217
San Antonio, TX 78258
Phone (210) 481-3119

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1184851073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BAYOU BLVD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031901",
            "telephone_number": "850-477-9253",
            "fax_number": "850-494-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BAYOU BLVD STE 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031901",
            "telephone_number": "850-477-9253",
            "fax_number": "850-494-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIS",
        "first_name": "JUSTIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-17",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "25967",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NE",
            "license": "25967",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NE",
            "license": "25967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.