Peter McLean Reynolds, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

C384340 Issued in CA

Practice address

4140 Jade St
Suite 100
Capitola, CA 95010-3956

Phone

(831) 475-4024

Fax

(831) 475-4344

NPI assigned

Aug 15, 2006

Last updated

Jan 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Orthonorcal, Inc.

  • Orthopaedic Surgery Physician
  • Los Gatos, CA
  • NPI 1124398235
  Medicare reassignment NPD
• Orthonorcal Inc

  • Orthopaedic Surgery Physician
  • Capitola, CA
  • NPI 1518412659
  NPD
• David H. Kim M.D. Inc.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Huntington Beach, CA
  • NPI 1972616142
  NPD (past)
• Santa Cruz Orthopaedic Institute a Medical Corporation

  • Specialist
  • Capitola, CA
  • NPI 1114029980
  NPD (past)
• Timothy W Gibson M D Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Huntington Beach, CA
  • NPI 1891808044
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1457364663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 102",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "831-475-4024",
            "fax_number": "831-475-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 JADE ST",
            "address_2": "SUITE 100",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950103956",
            "telephone_number": "831-475-4024",
            "fax_number": "831-475-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PETER",
        "middle_name": "MCLEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "C384340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "C384340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ransom, LMFT
• Michael S Reardon, M.D.
• Reggio RX
• Danielle Reyes, R.D.
• Fabian Reyes
• James Edward Riley, M.D.
• Carlos Guillermo Rios, ND
• Jessica Rivera
• Macie Rivera
• Anne Margaret Roemke, D.C.

• Sports Medicine (Orthopaedic Surgery) Physician in Capitola, CA
• Providers in Capitola, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.