Individual provider Active NPI

Manuel A. Reyes, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1245281708
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME64258 Issued in FL
Practice address
14011 Beach Blvd Ste 210-220
Jacksonville, FL 32250-1694
Phone
(904) 367-2277
Fax
(904) 421-3788
NPI assigned
May 12, 2006
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 72356 AZ
Family Medicine Physician 207Q00000X ME64258 FL Primary

Addresses

Primary practice location

14011 Beach Blvd Ste 210-220
Jacksonville, FL 32250-1694

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (904) 745-3618

Other practice location 1

14444 Beach Blvd Ste 28
Jacksonville, FL 32250-2080
Phone (904) 367-2277

Other identifiers 2

IdentifierTypeStateIssuer
373531100MedicaidFL
080146620OtherFLRAILROAD MEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20100114000126 FL Practitioner - Family Practice 1658412507 Reassigns benefits to 1 organization
I20220808001322 TX Practitioner - Family Practice 1658412507 Reassigns benefits to 3 organizations
I20240401002756 AZ Practitioner - Family Practice 1658412507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS IHS Phoenix AreaGroup PAC ID 2668647108, 23 clinicians

Practice addresses (Care Compare)

401 E Picacho Rd
Winterhaven, CA 92283-9605

401 Picacho Rd
Winterhaven, CA 92283-9605
Phone (760) 572-4137

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME64258FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS IHS Phoenix Area CurrentSince Aug 25, 2025 Accepting new patients
Archwell Health Professional Services of Arizona, LLC CurrentSince Mar 18, 2024 Accepting new patients
Santa Ana Health Center CurrentSince May 23, 2022 Accepting new patients
Albuquerque Indian Health Center CurrentSince May 23, 2022 Accepting new patients
Family Care Partners of Northeast Florida LLC Family Medicine PastSince Mar 20, 2025 Accepting new patients
Family Care Partners Urgent Care, LLC Past Accepting new patients
Baycare Medical Group Pediatric Walk-in, LLC Family Medicine Past Accepting new patients
Baycare Medical Group Pediatric Walk-in Care LLC Past Accepting new patients

Locations

4315 E Main St
Mesa, AZ 85205
Phone (480) 654-0260

2940 S 6th Ave
Tucson, AZ 85713
Phone (520) 613-1001

401 Picacho Rd
Winterhaven, CA 92283
Phone (760) 572-4100

801 Vassar Dr NE
Albuquerque, NM 87106
Phone (505) 248-4000

2 Dove Rd
#C
Bernalillo, NM 87004
Phone (505) 867-2497

4100 W 150th St
Cleveland, OH 44135

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27472/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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 1

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1245281708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "904-745-3618",
            "fax_number": "689-304-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14011 BEACH BLVD STE 210-220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501694",
            "telephone_number": "904-367-2277",
            "fax_number": "904-421-3788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14444 Beach Blvd Ste 28",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322502080",
            "country_code": "US",
            "telephone_number": "904-367-2277",
            "fax_number": "904-421-3788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "MANUEL",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "72356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME64258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "373531100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "080146620",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.