Individual provider Active NPI

Pedro Reyes Nieves, MD

  • Diagnostic Radiology Physician
  • San Juan, PR
National Provider Identifier
1407901994
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
9143 Issued in PR
Practice address
Jose Marti #56 Floral Park
San Juan, PR 00917
Phone
(787) 759-7878
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 9143 PR Primary

Addresses

Primary practice location

Jose Marti #56 Floral Park
San Juan, PR 00917

Mailing address

PO Box 364443
San Juan, PR 00936-4443
Phone (787) 759-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20040811000693 PR Practitioner - Diagnostic Radiology 5597737320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Puerto Rico School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CT Radiology Complex LLCGroup PAC ID 5597757526, 13 clinicians
CT Radiology Complex LLCGroup PAC ID 7810961737, 12 clinicians

Practice addresses (Care Compare)

1815 Carr
Suite 2
Bayamon, PR 00959-7279
Phone (787) 780-9069

CT Radiology Building 1815 Rd
Suite 2
Bayamon, PR 00959-7279
Phone (787) 780-2121

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CT Radiology Complex, LLC Diagnostic Radiology CurrentSince Apr 30, 2013 Accepting new patients
GRP Med CT Radiology Complex CurrentSince Apr 30, 2013 Accepting new patients
Diagnostic Imaging Center, PSC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407901994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364443",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009364443",
            "telephone_number": "787-759-8989",
            "fax_number": "787-756-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOSE MARTI #56 FLORAL PARK",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00917",
            "telephone_number": "787-759-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES NIEVES",
        "first_name": "PEDRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": "9143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.