Individual provider Active NPI

Paolo Angelo Santos Reyes, BSN, RN

  • Registered Nurse
  • Elmhurst, NY
National Provider Identifier
1386387447
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
830139-01 Issued in NY
Practice address
8610 54TH Ave
Elmhurst, NY 11373-4335
Phone
(401) 935-8634
NPI assigned
Apr 18, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 830139-01 NY Primary

Addresses

Primary practice location

8610 54TH Ave
Elmhurst, NY 11373-4335

Mailing address

8610 54TH Ave
Elmhurst, NY 11373-4335
Phone (401) 935-8634

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
830139-01NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1386387447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 54TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734335",
            "telephone_number": "401-935-8634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8610 54TH AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734335",
            "telephone_number": "401-935-8634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "PAOLO ANGELO",
        "middle_name": "SANTOS",
        "credential": "BSN, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "830139-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.