Individual provider Active NPI

Saint Don Niel Bautista Reyes, PT, ATP

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1457804239
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3362 Issued in NV
Practice address
5480 Cold Lake St
Las Vegas, NV 89148-7609
Phone
(702) 289-9797
NPI assigned
Jul 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3362 NV Primary

Addresses

Primary practice location

5480 Cold Lake St
Las Vegas, NV 89148-7609

Mailing address

5480 Cold Lake St
Las Vegas, NV 89148-7609
Phone (702) 289-9797

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170106000607 NV Practitioner - Physical Therapist in Private Practice 1355622366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Skyshroud Home Health Corp Physical Therapist CurrentSince Apr 28, 2024 Accepting new patients
Enlightened Transport LLC Current Accepting new patients
Rehabtronix LLC Current Accepting new patients
Summerland Mental Health LLC PastSince Jun 9, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1457804239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 COLD LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487609",
            "telephone_number": "702-289-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 COLD LAKE ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487609",
            "telephone_number": "702-289-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "SAINT DON NIEL",
        "middle_name": "BAUTISTA",
        "credential": "PT, ATP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.