Individual provider Active NPI

Michael A Reyes, M.D.

  • Family Medicine Physician
  • Northborough, MA
National Provider Identifier
1528040656
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
212154 Issued in MA
Practice address
333 SW Cutoff
Northborough, MA 01532-2130
Phone
(774) 570-5000
Fax
(774) 570-5070
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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 212154 MA Primary

Addresses

Primary practice location

333 SW Cutoff
Northborough, MA 01532-2130

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 1

IdentifierTypeStateIssuer
2010682MedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mreyes23596@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080327000291 MA Practitioner - Family Practice 5799861019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

333 SW Cutoff
Northborough, MA 01532-2130
Phone (774) 442-5695

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Preferred Transitions Home Health Care Inc Home health agency, Milford, MA, CCN 227666
  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212154MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Family Medicine CurrentSince Jun 30, 2017 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jun 30, 2017 Accepting new patients

Locations

333 SW Cutoff
Northborough, MA 01532
Phone (774) 570-5000

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: mreyes23596@umassmemorial.direct-ci.com

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1528040656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SW CUTOFF",
            "city": "NORTHBOROUGH",
            "state": "MA",
            "postal_code": "015322130",
            "telephone_number": "774-570-5000",
            "fax_number": "774-570-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "212154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010682",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreyes23596@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "333 SW Cutoff",
            "city": "Northborough",
            "state": "MA",
            "country_code": "US",
            "postal_code": "015322130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "333 SW Cutoff",
            "city": "Northborough",
            "state": "MA",
            "country_code": "US",
            "postal_code": "015322130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northborough, MA

Sources for this page

Verify at the official NPI Registry.