Active NPI
Roy R Reyes, MD
- Family Medicine Physician
- Pensacola, FL
National Provider Identifier
1336146406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME54994
- Practice address
- 4785 N 9TH Ave
Pensacola, FL 32503-2497 - Phone
- (850) 476-9691
- Fax
- (850) 476-0777
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME54994 | FL | |
| Family Medicine Physician | 207Q00000X | ME54994 | FL | Primary |
Addresses
Primary practice location
4785 N 9TH Ave
Pensacola, FL 32503-2497
Mailing address
4785 N 9TH Ave
Pensacola, FL 32503-2497
Phone (850) 476-9691
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00083199 | Other | FL | RAILROAD MEDICARE |
| 59169402 | Other | AL | BCBS AL |
| K0876 | Other | FL | MEDICARE GROUP NUMBER |
| 09113 | Other | FL | BCBS FL |
| 45147 | Other | FL | BC BS FL GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1336146406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4785 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032497",
"telephone_number": "850-476-9691",
"fax_number": "850-476-0777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4785 N 9TH AVE",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325032497",
"telephone_number": "850-476-9691",
"fax_number": "850-476-0777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ROY",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME54994",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME54994",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00083199",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS AL",
"identifier": "59169402",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "K0876",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FL",
"identifier": "09113",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS FL GROUP NUMBER",
"identifier": "45147",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.