Individual provider Active NPI

Susie Reyes, M.D.

  • Internal Medicine Physician
  • Redondo Beach, CA
National Provider Identifier
1609079854
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A95187 Issued in CA
Practice address
520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041
Phone
(310) 376-8816
Fax
(310) 374-2806
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A95187 CA Primary

Addresses

Primary practice location

520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041

Mailing address

520 N Prospect Ave
Suite 103
Redondo Beach, CA 90277-3041
Phone (310) 376-8816

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071012000397 CA Practitioner - Internal Medicine 9830285477 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

  • Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038

Merit-based Incentive Payment System (MIPS)

Final score
61 of 100Reported as group
Quality
59.41
Promoting interoperability
0
Improvement activities
40
Cost
71.45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95187CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince Dec 15, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara Internal Medicine Current Accepting new patients
County of Santa Clara CurrentSince Dec 15, 2018 Accepting new patients
County of Santa Clara CurrentSince Dec 15, 2018 Accepting new patients
County of Santa Clara CurrentSince Dec 15, 2018 Accepting new patients

Locations

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

1996 Lundy Ave
San Jose, CA 95131
Phone (408) 299-5846

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

2101 Alexian Dr
San Jose, CA 95116
Phone (408) 272-6050

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

660 S Fair Oaks Ave
Sunnyvale, CA 94086
Phone (408) 885-7366

Interoperability endpoints

  • Direct secure messaging: sreyes11381@santaclaravalley.direct-ci.net

Organizations & group practices 6

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 1

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268006400000",
    "number": "1609079854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE",
            "address_2": "SUITE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773041",
            "telephone_number": "310-376-8816",
            "fax_number": "310-374-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "SUSIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2010-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A95187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

Verify at the official NPI Registry.