Individual provider Active NPI

Manuel J. Reynosa, M.D.

  • Anesthesiology Physician
  • Ventura, CA
National Provider Identifier
1639190275
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G76600 Issued in CA
Practice address
147 N Brent St
Ventura, CA 93003-2809
Phone
(805) 652-5011
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G76600 CA Primary

Addresses

Primary practice location

147 N Brent St
Ventura, CA 93003-2809

Mailing address

11999 San Vicente Blvd
#440
Los Angeles, CA 90049-5131
Phone (310) 440-3131

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
I20040519001520 CA Practitioner - Anesthesiology 3971594102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of California, Geffen School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ventura Anesthesia Medical GroupGroup PAC ID 0648260836, 33 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
49.94 of 100Reported as group
Quality
38.91
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76600CAMDClinical Social Worker
G76600CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura Anesthesia Medical Group Anesthesiology CurrentSince Jul 1, 1996 Accepting new patients

Locations

11999 San Vicente Blvd
Ste 440
Los Angeles, CA 90049

3116 W March Ln
Ste 200
Stockton, CA 95219
Phone (510) 537-1234

2230 Lynn Rd
Ste 106
Thousand Oaks, CA 91360
Phone (805) 370-3137

1752 S Victoria Ave
Ste A
Ventura, CA 93003
Phone (805) 236-2734

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

2900 Townsgate Rd
Ste 201
Westlake Vlg, CA 91361
Phone (805) 496-6789

Organizations & group practices 1

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 10

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1639190275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "#440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-440-3131",
            "fax_number": "310-471-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 N BRENT ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032809",
            "telephone_number": "805-652-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOSA",
        "first_name": "MANUEL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G76600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.