NPIMap

Individual provider Active NPI

Mateo Reyes, MD

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1427040427
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K5676 Issued in TX
Practice address
3527 Jaime Zapata Memorial Hwy
Suite 101
Laredo, TX 78043-4788
Phone
(956) 722-5007
Fax
(956) 725-5894
NPI assigned
Aug 17, 2005
Last updated
Feb 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K5676 TX Primary

Addresses

Primary practice location

3527 Jaime Zapata Memorial Hwy
Suite 101
Laredo, TX 78043-4788

Mailing address

PO Box 451490
Laredo, TX 78045-0036
Phone (956) 722-5007

Other identifiers 3

IdentifierTypeStateIssuer
127104103MedicaidTX
127104106MedicaidTX
00728LOtherTXMEDICARE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040603001349 TX Practitioner - Family Practice 4284616178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Laredo Family Clinic PAGroup PAC ID 1153303037, 2 clinicians

Practice addresses (Care Compare)

3527 Jaime Zapata Memorial Hwy
Suite 101
Laredo, TX 78043-4788
Phone (956) 722-5007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K5676TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Laredo Family Clinic PA Family Medicine CurrentSince Apr 28, 2003 Accepting new patients
Val Verde County Hospital District Past Accepting new patients
City of Laredo Past Accepting new patients

Locations

3527 Jaime Zapata Memorial Hwy
Ste 101
Laredo, TX 78043
Phone (956) 722-5007

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1427040427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 451490",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780450036",
            "telephone_number": "956-722-5007",
            "fax_number": "956-725-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 JAIME ZAPATA MEMORIAL HWY",
            "address_2": "SUITE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780434788",
            "telephone_number": "956-722-5007",
            "fax_number": "956-725-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MATEO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127104103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127104106",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "00728L",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.