Individual provider Active NPI

Lorena Reyes, PTA

  • Physical Therapy Assistant
  • Traverse City, MI
National Provider Identifier
1699611020
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502004281 Issued in MI
Practice address
401 Munson Ave
Traverse City, MI 49686-3041
Phone
(231) 944-6541
NPI assigned
Apr 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502004281 MI Primary

Addresses

Primary practice location

401 Munson Ave
Traverse City, MI 49686-3041

Mailing address

401 Munson Ave
Traverse City, MI 49686-3041
Phone (231) 944-6541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5502004281MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1699611020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863041",
            "telephone_number": "231-944-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863041",
            "telephone_number": "231-944-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "LORENA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.