Individual provider Active NPI

Julio J. Rentas Reyes, M.D.

  • Neurology Physician
  • Camp Lejeune, NC
National Provider Identifier
1265417885
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
34342 Issued in SC
Practice address
100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone
(910) 450-4136
Fax
(910) 450-4558
NPI assigned
Dec 7, 2005
Last updated
Aug 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 30294 KS
Neurology Physician 2084N0400X 34342 SC Primary

Addresses

Primary practice location

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Mailing address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538
Phone (910) 450-4136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20120807000139 SC Practitioner - Neurology 3971759937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Inpatient Physicians LLCGroup PAC ID 4688671365, 9 clinicians

Practice addresses (Care Compare)

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (843) 824-3225

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (873) 782-2767

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 847-4372

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34342SCMDNeurology Physician
30294KSMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Inpatient Physicians, LLC Neurology CurrentSince Jul 1, 2012 Accepting new patients

Locations

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

295A Midland Pkwy
Summerville, SC 29485
Phone (843) 847-4372

Interoperability endpoints

  • Direct secure messaging: julio.rentas@hca5.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1265417885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4136",
            "fax_number": "910-450-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4136",
            "fax_number": "910-450-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENTAS REYES",
        "first_name": "JULIO",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "30294",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "34342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

Verify at the official NPI Registry.