NPIMap

Individual provider Active NPI

Chan Ngo Reyes, MD

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1497863161
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2002021173 Issued in MO
Practice address
440 E Tampa St
Springfield, MO 65806-1131
Phone
(417) 831-0150
Fax
(417) 831-0155
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2002021173 MO Primary

Addresses

Primary practice location

440 E Tampa St
Springfield, MO 65806-1131

Mailing address

PO Box 5681
Springfield, MO 65801-5681
Phone (417) 831-0150

Other identifiers 1

IdentifierTypeStateIssuer
209303437MedicaidMO

Other names 1

  • Chan Kwai Ngo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000001 MO Practitioner - Family Practice 2567425663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocates for a Healthy Community IncGroup PAC ID 5395653562, 55 clinicians

Practice addresses (Care Compare)

440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 831-0150

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocates for a Healthy Community, Inc CurrentSince Aug 16, 2004 Accepting new patients
Advocates for a Healthy Community Inc CurrentSince Aug 16, 2004 Accepting new patients
Mercy Hospital Springfield Past Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients
Advocates for a Healthy Community, Inc. Past Accepting new patients

Locations

440 E Tampa St
Springfield, MO 65806
Phone (417) 831-0191

Interoperability endpoints

  • Direct secure messaging: chan.reyes@cernerdirect.coxhealth.com
  • Direct secure messaging: creyes694615@direct.ochin.org
  • Direct secure messaging: chan.reyes.p1@direct.jordanvalley.nextgenshare.com

Organizations & group practices 5

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 12

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1497863161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5681",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658015681",
            "telephone_number": "417-831-0150",
            "fax_number": "417-831-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150",
            "fax_number": "417-831-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "CHAN",
        "middle_name": "NGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2002021173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209303437",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAN",
            "last_name": "NGO",
            "middle_name": "KWAI",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.