Individual provider Active NPI

Angel Manuel De Los Reyes, DC

  • Chiropractor
  • Orlando, FL
National Provider Identifier
1750628954
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH10807 Issued in FL
Practice address
953 N Semoran Blvd
Orlando, FL 32807-3528
Phone
(407) 282-3615
Fax
(407) 275-7221
NPI assigned
Jan 8, 2013
Last updated
Jan 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH10807 FL Primary

Addresses

Primary practice location

953 N Semoran Blvd
Orlando, FL 32807-3528

Mailing address

953 N Semoran Blvd
Orlando, FL 32807-3528
Phone (407) 282-3615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130311000319 FL Practitioner - ChiropracticPractitioner - General Practice 8426203803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: General Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Physical Medicine IncGroup PAC ID 3072761097, 3 clinicians

Practice addresses (Care Compare)

953 N Semoran Blvd
Orlando, FL 32807-3528
Phone (407) 392-0378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH10807FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Health Chiropratic Solutions, LLC Chiropractor CurrentSince Jan 12, 2013 Accepting new patients
Advanced Physical Medicine Inc CurrentSince Jan 12, 2013 Accepting new patients
Advanced Physical Medicine Inc CurrentSince Jan 12, 2013 Accepting new patients

Locations

2920 Pleasant Hill Rd
Kissimmee, FL 34746
Phone (407) 282-3516

12554 S John Young Pkwy
Ste 103
Orlando, FL 32837
Phone (407) 282-3615

953 N Semoran Blvd
Orlando, FL 32807
Phone (407) 282-3615

Networks

  • Freedom Health HMO Network

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": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1750628954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "953 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073528",
            "telephone_number": "407-282-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 N SEMORAN BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073528",
            "telephone_number": "407-282-3615",
            "fax_number": "407-275-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS REYES",
        "first_name": "ANGEL",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.