Individual provider Active NPI

Kevin Reyes

  • Psychiatry Physician
  • Las Vegas, NV
National Provider Identifier
1316364672
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO2335 Issued in NV
Practice address
6171 W Charleston Blvd BLDG 17
Las Vegas, NV 89146-1126
Phone
(702) 670-0588
NPI assigned
Mar 25, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DO2335 NV Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

6171 W Charleston Blvd BLDG 17
Las Vegas, NV 89146-1126

Mailing address

11035 Lavender Hill Dr Ste 160-154
Las Vegas, NV 89135-2955
Phone (702) 670-0588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180628000932 NV Practitioner - Psychiatry 3274753074 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Firstmed Health and Wellness Center IncGroup PAC ID 7416126362, 14 clinicians

Practice addresses (Care Compare)

3343 S Eastern Ave
Las Vegas, NV 89169-3312

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt General Hospital Current Accepting new patients
Anywhere Clinic LLC Psychiatry CurrentSince Jun 1, 2018 Accepting new patients
Humboldt General Hospital CurrentSince Jan 1, 2021 Accepting new patients
Humboldt General Hospital CurrentSince Jan 1, 2021 Accepting new patients
Lisa a Durette MD PLLC Psychiatry Past Accepting new patients
State of Nevada - DWTC Past Accepting new patients

Locations

4029 Dean Martin Dr
Las Vegas, NV 89103
Phone (702) 919-1508

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1316364672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 LAVENDER HILL DR STE 160-154",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891352955",
            "telephone_number": "702-670-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 W CHARLESTON BLVD BLDG 17",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891461126",
            "telephone_number": "702-670-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-25",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NV",
            "license": "DO2335",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.