Jorge Ricardo Reyes II, MD
Individual provider Active NPI Family Medicine Physician · Manati, PR
NPI 1639739238 · NPPES record last updated Jan 23, 2023
Key facts
- NPI
- 1639739238
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34-098-R (PR)
- Practice address
- Calle Hernandez Carrion
Manati, PR 00674 - Phone
- (787) 621-3700
- NPI assigned
- Jun 17, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240229004195 | PR | Practitioner - Family Practice | 7517326887 | Practice locations: Fajardo, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34-098-R | PR | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34-098-R | PR | Yes |
Addresses
Primary practice location
Calle Hernandez Carrion
Manati, PR 00674
Mailing address
111 Calle Cecilio Urbina
Portal de Sofia Apt 2402
Guaynabo, PR 00969
Phone (787) 506-4214
NPI Registry JSON
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1639739238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 CALLE CECILIO URBINA",
"address_2": "PORTAL DE SOFIA APT 2402",
"city": "GUAYNABO",
"state": "PR",
"postal_code": "00969",
"telephone_number": "787-506-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CALLE HERNANDEZ CARRION",
"city": "MANATI",
"state": "PR",
"postal_code": "00674",
"telephone_number": "787-621-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "JORGE",
"middle_name": "RICARDO",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-17",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PR",
"license": "34-098-R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manati, PR
- Marta I Repolet
- Retina Center of Puerto Rico P S C
- Ivana Paola Rey Pelet
- Lidia I Reyes Nieves
- Onix Reyes-Martinez
- Miguel Angel Reyes
- Noelis Isabel Reyes
- Enrique L. Rios Alameda
- Coralys Rios Ayala
- Fabiola Cristina Rios de Choudens
All providers in Manati, PR · Family Medicine Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.