Odin Delos Reyes, D.P.M

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

CT 000 680 Issued in CT

Practice address

1 Pomperaug Office Park
Suite 105
Southbury, CT 06488-2295

Phone

(203) 262-6100

Fax

(203) 264-6679

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: odin.delosreyes@chcict.eclinicaldirectplus.com

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.

• Odin de Los Reyes DPM Inc

  • Primary Podiatric Medicine Podiatrist
  • Southbury, CT
  • NPI 1205050630
  Medicare reassignment NPD Authorized official
• Odin de Los Reyes DPM Inc

  • Primary Podiatric Medicine Podiatrist
  • New Britain, CT
  • NPI 1841461936
  NPD Authorized official
• Feel Well Health Center of Southington, P.C.

  • Internal Medicine Physician
  • Plantsville, CT
  • NPI 1548305584
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1679682249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 105",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882295",
            "telephone_number": "203-262-6100",
            "fax_number": "203-264-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 105",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882295",
            "telephone_number": "203-262-6100",
            "fax_number": "203-264-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOS REYES",
        "first_name": "ODIN",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CT",
            "license": "CT 000 680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "480026445",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004186947",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph De Beauvoir, M.D.
• Michael De Luca, PT
• Gregory Gerard Decandia, MD
• Annmarie Delessio-Matta, D.M.D.
• Rhea Caitlin Dell'Orletta, OTR/L
• Christopher Edward Dembski, D.C.
• Saldy John Delariarte Deocampo, P.T
• Logan Deros
• Emily Terese Diaferio, OTR/L
• Diagnostic Imaging of Southbury

• Primary Podiatric Medicine Podiatrist in Southbury, CT
• Providers in Southbury, CT by specialty
• Primary Podiatric Medicine Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.