Rodney Sam Reyes, BA, ADV. CASAC-G

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

28646 Issued in NY

Practice address

770 E 176TH St
Bronx, NY 10460-4617

Phone

(929) 306-7951

NPI assigned

Apr 9, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Rodney Sam Reyes Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1407242191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 ST 176",
            "address_2": "630 CONCORD AVENUE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104551045",
            "telephone_number": "929-306-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 E 176TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104604617",
            "telephone_number": "929-306-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "RODNEY",
        "middle_name": "SAM",
        "name_prefix": "Mr.",
        "credential": "BA, ADV. CASAC-G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "28646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODNEY",
            "last_name": "REYES",
            "middle_name": "SAM",
            "prefix": "MR.",
            "credential": "BA, ADV. CASAC-G",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Melida Aralis Reyes, MFT
• Natalie Angelina Reyes, LMSW
• Nelton E Reyes, M.D
• Paola Celline Reyes
• Peachy M Reyes, RPT
• Rowena Reyes, N.P.
• Sandra Reyes
• Sofia Marlene Reyes, MD
• Taina Reyes
• Yelitza Reyes, LCSW

• Substance Abuse Rehabilitation Facility in Bronx, NY
• Providers in Bronx, NY by specialty
• Substance Abuse Rehabilitation Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.