Active NPI
Michael John Reyes, M.D.
- Orthopaedic Surgery Physician
- Edmonds, WA
National Provider Identifier
1750501946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 2003013122
- Practice address
- 21401 72ND Ave W
Edmonds, WA 98026-7702 - Phone
- (425) 774-2636
- Fax
- (425) 774-2688
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2003013122 | MO | Primary |
Addresses
Primary practice location
21401 72ND Ave W
Edmonds, WA 98026-7702
Mailing address
21401 72ND Ave W
Edmonds, WA 98026-7702
Phone (425) 774-2636
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003013122 | MO | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385942400000",
"number": "1750501946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21401 72ND AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267702",
"telephone_number": "425-774-2636",
"fax_number": "425-774-2688"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21401 72ND AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267702",
"telephone_number": "425-774-2636",
"fax_number": "425-774-2688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-27",
"last_updated": "2013-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "2003013122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.