NPIMap

Organization Active NPI

Adoracion Reyes MD a Professional Medical Corporation

  • Family Nurse Practitioner
  • Artesia, CA
National Provider Identifier
1457196164
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ADORACION REYES MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
11618 South St Ste 214
Artesia, CA 90701-6618
Phone
(562) 310-6703
NPI assigned
Jun 26, 2024
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Sheryl Antido, MDNPI 1013407519
Title
Ceo
Phone
(562) 310-6703

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

11618 South St Ste 214
Artesia, CA 90701-6618

Mailing address

11618 South St Ste 214
Artesia, CA 90701-6618
Phone (562) 310-6703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240829002264 CA Part B Supplier - Clinic/Group Practice 3779022181 Receives reassigned benefits from 9 practitioners
Practice locations: Artesia, CA

National Provider Directory

National Provider Directory

Locations

11618 South St
Ste 213
Artesia, CA 90701
Phone (562) 310-6703

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1457196164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11618 SOUTH ST STE 214",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907016618",
            "telephone_number": "562-310-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11618 SOUTH ST STE 214",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907016618",
            "telephone_number": "562-310-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADORACION REYES MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "ANTIDO",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-310-6703",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.