Ericson P Reyes

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP15834 Issued in CA

Practice address

3300 E South St Ste 308
Lakewood, CA 90805-4598

Phone

(562) 630-3111

Fax

(562) 630-3107

NPI assigned

Aug 25, 2006

Last updated

Oct 10, 2023By the provider in NPPES

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southland Renal Medical Group IncGroup PAC ID 3476580838, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ereyesnp173687@direct.memorialcare.org

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.

• Southland Renal Medical Group, Inc.

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1730110495
  Medicare reassignment Care Compare group NPD
• Southland Renal Medical Group, Inc

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1447383971
  NPD
• Southland Renal Medical Group, Inc

  • Nephrology Physician
  • Long Beach, CA
  • NPI 1851589600
  NPD
• Southland Renal Medical Group, Inc.

  • Nephrology Physician
  • Los Alamitos, CA
  • NPI 1205969748
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1740397413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 879",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907140879",
            "telephone_number": "562-630-3111",
            "fax_number": "562-630-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E SOUTH ST STE 308",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "908054598",
            "telephone_number": "562-630-3111",
            "fax_number": "562-630-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ERICSON",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP15834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENS",
            "identifier": "NP15834",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "515085",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhaemae Reid
• Reivyn Home Health Inc
• Reliance Transportation Inc
• Amber Rentie
• Ana Resendez
• Jo Yvette Reyes, NP
• Joselle Reyes
• Marleen Reyes
• Matthew Reyna
• Florabel Reynoso, L.P.T.A

• Nurse Practitioner in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.