Individual provider Active NPI

Carmen Lydia Reyes, M.D.

  • General Practice Physician
  • Caguas, PR
National Provider Identifier
1689649352
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11626 Issued in PR
Practice address
Cond Bonneville
Calle 2 F19
Caguas, PR 00725-5606
Phone
(787) 744-4721
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11626 PR Primary

Addresses

Primary practice location

Cond Bonneville
Calle 2 F19
Caguas, PR 00725-5606

Mailing address

Cond Bonneville
Calle 2 F19
Caguas, PR 00725-5606
Phone (787) 744-4721

Other identifiers 1

IdentifierTypeStateIssuer
11626OtherPRMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20070723000290 PR Practitioner - General Practice 2769583673 Reassigns benefits to 1 organization
Practice locations: Caguas, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Tiger Med CorpGroup PAC ID 3476707258, 13 clinicians

Practice addresses (Care Compare)

3 Calle Munoz Rivera
Caguas, PR 00725-2602
Phone (787) 286-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11626PRMDClinical Social Worker

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1689649352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COND BONNEVILLE",
            "address_2": "CALLE 2 F19",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007255606",
            "telephone_number": "787-744-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COND BONNEVILLE",
            "address_2": "CALLE 2 F19",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007255606",
            "telephone_number": "787-744-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "CARMEN",
        "middle_name": "LYDIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "11626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "11626",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.