Individual provider Active NPI

Lavinia T Reyes, MD

  • Internal Medicine Physician
  • Raleigh, NC
National Provider Identifier
1467498840
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9701126 Issued in NC
Practice address
11081 Forest Pines Dr
Suite 124
Raleigh, NC 27614-7655
Phone
(919) 435-6111
Fax
(919) 435-6113
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9701126 NC Primary

Addresses

Primary practice location

11081 Forest Pines Dr
Suite 124
Raleigh, NC 27614-7655

Mailing address

12200 Pawleys Mill Cir
Raleigh, NC 27614-7976
Phone (919) 435-6111

Other identifiers 1

IdentifierTypeStateIssuer
8910888MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lavinia.Reyes.1@10047.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20060110001183 NC Practitioner - Internal MedicinePractitioner - Family Practice 9133142698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

11081 Forest Pines Dr
Suite 124
Raleigh, NC 27614-7656
Phone (919) 435-6111

1501 N Bickett Blvd
Suite F
Louisburg, NC 27549-2178
Phone (919) 497-8414

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Wakefield Internal Medicine CurrentSince Dec 1, 2014 Accepting new patients
Louisburg Hma Physician Management, LLC Internal Medicine Past Accepting new patients

Locations

11081 Forest Pines Dr
Ste 124
Raleigh, NC 27614
Phone (919) 435-6111

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10047/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1467498840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 PAWLEYS MILL CIR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147976",
            "telephone_number": "919-435-6111",
            "fax_number": "919-435-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11081 FOREST PINES DR",
            "address_2": "SUITE 124",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276147655",
            "telephone_number": "919-435-6111",
            "fax_number": "919-435-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LAVINIA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9701126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910888",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lavinia.Reyes.1@10047.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "11081 Forest Pines Dr",
            "address_2": "Suite 124",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276147655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.