Individual provider Active NPI

Joseph Reyes, OD

  • Optometrist
  • Bonita Springs, FL
National Provider Identifier
1477505808
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3045 Issued in FL
Practice address
26381 S Tamiami TRL
Ste 112
Bonita Springs, FL 34134-7803
Phone
(239) 992-2020
Fax
(239) 992-2005
NPI assigned
May 16, 2006
Last updated
Apr 24, 2024By the provider in NPPES
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
Optometrist 152W00000X OPC3045 FL Primary

Addresses

Primary practice location

26381 S Tamiami TRL
Ste 112
Bonita Springs, FL 34134-7803

Mailing address

26381 S Tamiami TRL
Ste 112
Bonita Springs, FL 34134-7803
Phone (239) 992-2020

Other identifiers 4

IdentifierTypeStateIssuer
620218700MedicaidFL
20730OtherFLBLUE CROSS BLUE SHIELD
7023203OtherFLCIGNA
7084213OtherFLAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070716000324 FL Practitioner - Optometry 1759481005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Eye Care of Florida PAGroup PAC ID 7911156989, 2 clinicians

Practice addresses (Care Compare)

26381 S Tamiami TRL
Suite 112
Bonita Springs, FL 34134-7803
Phone (239) 992-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3045FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Eye Care of Florida P.a. Optometrist CurrentSince Nov 29, 2009 Accepting new patients
Associates in Eyecare of Florida Optometrist PastSince Nov 29, 2009 Accepting new patients
Eye Centers of Florida Optometrist Past Accepting new patients

Locations

26381 S Tamiami Trl
Ste 112
Bonita Springs, FL 34134
Phone (239) 992-2020

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1477505808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26381 S TAMIAMI TRL",
            "address_2": "STE 112",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347803",
            "telephone_number": "239-992-2020",
            "fax_number": "239-992-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26381 S TAMIAMI TRL",
            "address_2": "STE 112",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347803",
            "telephone_number": "239-992-2020",
            "fax_number": "239-992-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JOSEPH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620218700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "20730",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7023203",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7084213",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.