Individual provider Active NPI

Nicolas Reyes, MD

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1710484704
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A166783 Issued in CA
Practice address
6400 E Pacific Coast Hwy Ste D210
Long Beach, CA 90803-4265
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Apr 6, 2018
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A166783 CA Primary

Addresses

Primary practice location

6400 E Pacific Coast Hwy Ste D210
Long Beach, CA 90803-4265

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other names 1

  • Nicolas Derr Former name

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
I20220614001587 CA Practitioner - Family Practice 3971911876 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
One Medical Seniors Group IncGroup PAC ID 1759769151, 53 clinicians

Practice addresses (Care Compare)

6460 E Pacific Coast Hwy
Suite D 210
Long Beach, CA 90803-4271
Phone (562) 270-9997

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A166783CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Jan 8, 2024 Accepting new patients
One Medical Seniors Group, Inc. Family Medicine CurrentSince Mar 27, 2024 Accepting new patients
Providence Saint Johns Medical Foundation Family Medicine CurrentSince Jan 8, 2024 Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

10000 Washington Blvd
Ste 108
Culver City, CA 90232
Phone (310) 500-2045

6400 E Pacific Coast Hwy
Ste D210
Long Beach, CA 90803

6460 E Pacific Coast Hwy
Ste D210
Long Beach, CA 90803
Phone (562) 270-9997

1 Embarcadero Ctr
Ste 1900
San Francisco, CA 94111

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

Interoperability endpoints

  • Direct secure messaging: nreyes1007924@direct.uclahealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1710484704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 E PACIFIC COAST HWY STE D210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034265",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "NICOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-06",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A166783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLAS",
            "last_name": "DERR",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.