Individual provider Active NPI

Camellia Mayra Reyes, AA

  • Anesthesiologist Assistant
  • Houston, TX
National Provider Identifier
1720453210
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
3048 Issued in TX
Practice address
2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817
Phone
(713) 620-4000
NPI assigned
Dec 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 3048 TX Primary

Addresses

Primary practice location

2411 Fountain View Dr
Ste. 200
Houston, TX 77057-4817

Mailing address

PO Box 650865
Dallas, TX 75265-0865
Phone (713) 620-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160107002947 TX Practitioner - Anesthesiology Assistant 7810299823 Reassigns benefits to 1 organization
I20171213001159 FL Practitioner - Anesthesiology Assistant 7810299823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
3048TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Anesthesia Consultants, Inc. CurrentSince Dec 20, 2017 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiologist Assistant CurrentSince Dec 1, 2015 Accepting new patients
U S Anesthesia Partners of Texas, PA CurrentSince Dec 1, 2015 Accepting new patients
North Florida Anesthesia Consultants Inc CurrentSince Dec 20, 2017 Accepting new patients

Locations

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

2411 Fountain View Dr
Ste 200
Houston, TX 77057
Phone (713) 458-4185

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1720453210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650865",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650865",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 FOUNTAIN VIEW DR",
            "address_2": "STE. 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770574817",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "CAMELLIA",
        "middle_name": "MAYRA",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "3048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.