Individual provider Active NPI

Juan Reyes

  • Critical Care Medicine Registered Nurse
  • Carolina, PR
National Provider Identifier
1770462079
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
95293371 Issued in CA
Practice address
Calle 30 U15
Urb Metropolis
Carolina, PR 00987
Phone
(305) 915-5367
NPI assigned
Aug 29, 2025
Last updated
Aug 29, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 105324G PR
Critical Care Medicine Registered Nurse 163WC0200X 95293371 CA Primary

Addresses

Primary practice location

Calle 30 U15
Urb Metropolis
Carolina, PR 00987

Mailing address

Calle 30 U15
Urb Metropolis
Carolina, PR 00987
Phone (305) 915-5367

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95293371CAMDCritical Care Medicine Registered Nurse
105324GPRMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1770462079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE 30 U15",
            "address_2": "URB METROPOLIS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "305-915-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 30 U15",
            "address_2": "URB METROPOLIS",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "305-915-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "PR",
            "license": "105324G",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95293371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.