Nicolas Emmanuel Echon Reyes, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9561370 Issued in ID

Practice address

6051 W Emerald St
Boise, ID 83704-8969

Phone

(208) 303-2515

Fax

(208) 302-5155

NPI assigned

Jun 29, 2022

Last updated

Oct 4, 2024By 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

Medicare fee-for-service enrollment

Enrolled in ID

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Clinics IncGroup PAC ID 4082527353, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nreyes2812735@direct.trinity-health.org
• Direct secure messaging: nreyes681858@direct.ochin.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.

• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1457309122

  Physician Assistant

  Medicare reassignment Care Compare group NPD (past)
• Saint Alphonsus Medical Center- Ontario Inc

  • Internal Medicine Physician
  • Ontario, OR
  • NPI 1093034159

  ID

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716
  Medicare reassignment
• Community Health Clinics, Inc.

  dba Terry Reilly - Vista

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1346254026
  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1689688459
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  NPD
• Saint Alphonsus Medical Center- Ontario Inc

  dba Saint Alphonsus Medical Center Ontario

  • General Acute Care Hospital
  • Ontario, OR
  • NPI 1891891792
  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1134527708

  Physician Assistant

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Meridian, ID
  • NPI 1215941083

  Physician Assistant

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Homedale, ID
  • NPI 1386757235

  Physician Assistant

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Melba, ID
  • NPI 1578574521

  Physician Assistant

  NPD (past)
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Substance Abuse Rehabilitation Facility
  • Boise, ID
  • NPI 1598097263
  NPD (past)

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

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1760114425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-303-2515",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 1st St S",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836513703",
            "country_code": "US",
            "telephone_number": "208-466-7869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "NICOLAS",
        "middle_name": "EMMANUEL ECHON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "9561370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revive Mental Wellness LLC
• Revolutionary Medicine of Idaho
• Anastasia Pearl Reyes, PT, DPT, CSCS
• Krystal Reyes, P.T.
• Lorena Aguilar Reyes, OTR/L
• Oscar Reyes, LMSW
• Shirley Reyes
• Adam C Reynolds, M.D.
• Allyson R Reynolds, NP
• Charles M Reynolds, M.D.

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.