Individual provider Active NPI

Jose Reyes, M.D.

  • Emergency Medicine Physician
  • Decatur, IL
National Provider Identifier
1366469991
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Practice address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone
(217) 464-2966
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA05453400 NJ
Emergency Medicine Physician 207P00000X IL Primary

Addresses

Primary practice location

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Mailing address

75 Remitt Drive
Lockbox 1707
Chicago, IL 60675-1707
Phone (866) 916-5259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20060106000388 IL Practitioner - Internal MedicinePractitioner - Emergency Medicine 8527081488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iems Physician Services PLLCGroup PAC ID 2567802556, 64 clinicians

Practice addresses (Care Compare)

1400 W Park St
Urbana, IL 61801-2334
Phone (217) 337-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-081174ILMDEmergency Medicine Physician
25MA05453400NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iems Physician Services PLLC Emergency Medicine CurrentSince May 13, 2024 Accepting new patients
Central Illinois Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Illinois Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Locations

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

Organizations & group practices 4

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.

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1366469991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITT DRIVE",
            "address_2": "LOCKBOX 1707",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751707",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JOSE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA05453400",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.