Individual provider Active NPI

Abel Reyes, TEACHER

  • Contractor
  • Bronx, NY
National Provider Identifier
1467886929
Registry record updated Sep 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
558281 Issued in NY
Practice address
710 Tinton Ave
Apt. 8a
Bronx, NY 10455-2216
Phone
(718) 402-9092
NPI assigned
Sep 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 558281 NY Primary

Addresses

Primary practice location

710 Tinton Ave
Apt. 8a
Bronx, NY 10455-2216

Mailing address

710 Tinton Ave
Apt. 8a
Bronx, NY 10455-2216
Phone (718) 402-9092

Other names 1

  • Mr. Adewale Ogungbemi Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
558281NYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1378080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378080000000",
    "number": "1467886929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 TINTON AVE",
            "address_2": "APT. 8A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104552216",
            "telephone_number": "718-402-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 TINTON AVE",
            "address_2": "APT. 8A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104552216",
            "telephone_number": "718-402-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ABEL",
        "name_prefix": "Mr.",
        "credential": "TEACHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-02",
        "last_updated": "2013-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "558281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADEWALE",
            "last_name": "OGUNGBEMI",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.