Individual provider Active NPI

Jonathan Villaroman Reyes, M.D.

  • Pediatrics Physician
  • Edison, NJ
National Provider Identifier
1780602177
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07160300 Issued in NJ
Practice address
2 Lincoln Hwy Ste 500
Edison, NJ 08820-3961
Phone
(732) 516-9868
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07160300 NJ Primary

Addresses

Primary practice location

2 Lincoln Hwy Ste 500
Edison, NJ 08820-3961

Mailing address

2 Lincoln Hwy Ste 500
Edison, NJ 08820-3961
Phone (732) 516-9868

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070619000396 NJ Practitioner - Pediatric Medicine 8527167493 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07160300NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Pediatrics, PC Pediatrics CurrentSince Jan 12, 2022 Accepting new patients
The Radiology Group of New Jersey, LLC CurrentSince Mar 1, 2025 Accepting new patients
Kinder Pediatric Care LLC CurrentSince Jun 21, 2022 Accepting new patients
Ila Sukhadia, Medical, P.C. Past Accepting new patients
Rutgers Health-RWJ Pediatric Critical Care Pediatrics Past Accepting new patients
Monmouth Digestive Health LLC PastSince Aug 17, 2020 Accepting new patients
Middlesex Emergency Physicians, P.a. Emergency Medicine Past Accepting new patients

Locations

145 Wyckoff Rd
Ste 201
Eatontown, NJ 07724
Phone (732) 597-7333

2 State Route 27
Ste 500
Edison, NJ 08820
Phone (732) 516-9868

2 State Route 27
Ste 510
Edison, NJ 08820
Phone (732) 516-9868

57 US Highway 46
Ste 212
Hackettstown, NJ 07840

651 Willow Grove St
Hackettstown, NJ 07840
Phone (908) 441-1161

175 High St
Newton, NJ 07860
Phone (973) 383-2121

567 Fischer Blvd
Toms River, NJ 08753
Phone (732) 280-2727

565 Fischer Blvd
Toms River, NJ 08753
Phone (732) 506-6868

Organizations & group practices 7

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1780602177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY STE 500",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-516-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN HWY STE 500",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203961",
            "telephone_number": "732-516-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JONATHAN",
        "middle_name": "VILLAROMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07160300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.