Reynaldo L Reyes Jr., PHYSICIAN ASSISTANT

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

35000 Guadalcanal St
Branch Medical Clinic Marine Corps Recruit Depot
San Diego, CA 92140

Phone

(619) 532-4056

NPI assigned

Apr 13, 2006

Last updated

Sep 22, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: reynaldo.reyes@opsam.eclinicaldirectplus.com

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.

• Operation Samahan, Inc.

  dba Samahan Health Centers

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1871680397
  Medicare reassignment NPD (past)
• Operation Samahan Inc

  dba Opsam Health

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1376358549
  NPD
• Operation Samahan, Inc.

  dba Opsam Health

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1194616268
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1306800644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12497 CONQUISTADOR WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282152",
            "telephone_number": "858-603-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST",
            "address_2": "BRANCH MEDICAL CLINIC MARINE CORPS RECRUIT DEPOT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92140",
            "telephone_number": "619-532-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "REYNALDO",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58601",
            "primary": false
        },
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patty Reyes, VN
• Paula Katrina Sibulo Reyes, RPH
• Rafael M Reyes, PSYD
• Raquel R Reyes, D.D.S.
• Rebecca Reyes
• Ronald Reyes
• Ruby Chao Reyes, DDS
• Rudy A Reyes, D.C.
• Ryan Douglas Reyes, DDS
• Sallie Reyes, PA

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.