Individual provider Active NPI

Christian Reyes, DPT

  • Physical Therapist
  • Rockville, MD
National Provider Identifier
1821344946
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23950 Issued in MD
Practice address
15245 Shady Grove Rd
C-100
Rockville, MD 20850-3222
Phone
(301) 417-2652
NPI assigned
Jul 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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 23950 MD Primary

Addresses

Primary practice location

15245 Shady Grove Rd
C-100
Rockville, MD 20850-3222

Mailing address

6429 Rock Forest Dr
406
Bethesda, MD 20817-7938

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260416003944 TX Practitioner - Physical Therapist in Private Practice 9436396942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

607 Indian Health Rd
Pine Ridge, SD 57770-3169

6429 Rock Forest Dr
Bethesda, MD 20817-7938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23950MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Therapy & Wellness LLC Past Accepting new patients
Montgomery Therapy, LLC PastSince Jul 20, 2011 Accepting new patients

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": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1821344946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6429 ROCK FOREST DR",
            "address_2": "406",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD",
            "address_2": "C-100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503222",
            "telephone_number": "301-417-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.