Individual provider Active NPI

Juanito E Reyes, PT

  • Physical Therapist
  • Baldwin, NY
National Provider Identifier
1780639997
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
024010 Issued in NY
Practice address
830 Atlantic Ave
Baldwin, NY 11510-4098
Phone
(516) 867-5050
Fax
(516) 867-0868
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 024010 NY Primary

Addresses

Primary practice location

830 Atlantic Ave
Baldwin, NY 11510-4098

Mailing address

830 Atlantic Ave
Baldwin, NY 11510-4098
Phone (516) 867-5050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707001178 NY Practitioner - Physical Therapist in Private Practice 0143208132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

807 Atlantic Ave
Baldwin, NY 11510-4011
Phone (516) 867-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
024010NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reyes/Reyes Physical Therapy PLLC Physical Therapist CurrentSince Sep 3, 2009 Accepting new patients
South Shore Neurologic Associates, PC Past Accepting new patients

Locations

830 Atlantic Ave
Baldwin, NY 11510
Phone (516) 867-5050

807 Atlantic Ave
Baldwin, NY 11510
Phone (516) 867-5050

Organizations & group practices 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1780639997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 ATLANTIC AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104098",
            "telephone_number": "516-867-5050",
            "fax_number": "516-867-0868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ATLANTIC AVE",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104098",
            "telephone_number": "516-867-5050",
            "fax_number": "516-867-0868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JUANITO",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.