Ivan Javier Reyes-Rufo, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OL60557601 Issued in WA

Practice address

900 S Auburn St
Ste a
Kennewick, WA 99336-5621

Phone

(773) 425-0321

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

Yes

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 OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Internal Medicine

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455

  Internal Medicine

  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1780078733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 STEPTOE ST",
            "address_2": "121",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993528539",
            "telephone_number": "773-425-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S AUBURN ST",
            "address_2": "STE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993365621",
            "telephone_number": "773-425-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES-RUFO",
        "first_name": "IVAN",
        "middle_name": "JAVIER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OL60557601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revival Adult Family Home LLC
• Annika Rose Rex
• Anayantzi Reyes Gonzalez, CMI-SPANISH
• Lizbeth Reyes Soto
• Alexandra Reyes-Herrera
• Alma E Reyes
• Rubi Reyes
• Kellie Renee Reynolds, LP
• Marla K Reynolds
• Sara Barbara Reynoso

• Internal Medicine Physician in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.