Individual provider Active NPI

Andrew Joseph Reyes, DNP, APN, FNP-BC

  • Family Nurse Practitioner
  • New Providence, NJ
National Provider Identifier
1770366171
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14902900 Issued in NJ
Practice address
890 Mountain Ave FL 2
New Providence, NJ 07974-1218
Phone
(908) 988-4293
NPI assigned
Aug 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26NJ14902900 NJ
Pain Medicine Physician 208VP0000X 26NJ14902900 NJ
Interventional Pain Medicine Physician 208VP0014X 26NJ14902900 NJ
Family Nurse Practitioner 363LF0000X 26NJ14902900 NJ Primary

Addresses

Primary practice location

890 Mountain Ave FL 2
New Providence, NJ 07974-1218

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20231110001423 NJ Practitioner - Nurse Practitioner 7113374281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ14902900NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Oct 9, 2023 Accepting new patients
Summit Medical Group PA CurrentSince Oct 9, 2023 Accepting new patients
Summit Medical Group, Inc Family Medicine PastSince Aug 27, 2023 Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

890 Mountain Ave
Fl 2
New Providence, NJ 07974
Phone (908) 988-4293

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

890 Mountain Ave
New Providence, NJ 07974
Phone (908) 277-8799

Interoperability endpoints

  • Direct secure messaging: andrew.reyes.1@2983.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1770366171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 MOUNTAIN AVE FL 2",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741218",
            "telephone_number": "908-988-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "DNP, APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ14902900",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NJ",
            "license": "26NJ14902900",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "26NJ14902900",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14902900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Providence, NJ

Sources for this page

Verify at the official NPI Registry.