Individual provider Active NPI

Toni Marie Reyes, FNP

  • Family Nurse Practitioner
  • Upland, CA
National Provider Identifier
1528456050
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001610 Issued in CA
Practice address
1183 E Foothill Blvd
Ste 135
Upland, CA 91786-4079
Phone
(909) 931-1368
NPI assigned
Jan 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001610 CA Primary

Addresses

Primary practice location

1183 E Foothill Blvd
Ste 135
Upland, CA 91786-4079

Mailing address

1146 Sunset CT
Upland, CA 91784-1082
Phone (909) 969-4577

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171115000537 CA Practitioner - Nurse Practitioner 9830455419 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 14, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 14, 2019 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Unicare Community Health Center, Inc. CurrentSince Oct 2, 2017 Accepting new patients

Locations

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

570 S Mount Vernon Ave
Ste G
San Bernardino, CA 92410
Phone (909) 884-6700

1183 E Foothill Blvd
Ste 135
Upland, CA 91786
Phone (909) 844-2090

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.

NPI Registry JSON

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1528456050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 SUNSET CT",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917841082",
            "telephone_number": "909-969-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "STE 135",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864079",
            "telephone_number": "909-931-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "TONI",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.