Individual provider Active NPI

John Emmanuel Delos Reyes, MS, RDN

  • Registered Dietitian
  • Staten Island, NY
National Provider Identifier
1831828136
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
010985 Issued in NY
Practice address
256 Mason Ave BLDG C3
Staten Island, NY 10305-3408
Phone
(718) 226-1300
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 010985 NY Primary

Addresses

Primary practice location

256 Mason Ave BLDG C3
Staten Island, NY 10305-3408

Mailing address

2602 Wildberry CT
Edison, NJ 08817-2756

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdelosreyes@northwell.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613001601 NY Practitioner - Registered Dietitian Or Nutrition Professional 7113384769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

242 Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6832

256 Mason Ave
Staten Island, NY 10305-3408

256 Mason Ave B
Staten Island, NY 10305-3408
Phone (718) 226-1595

256 Mason Aveunue
Staten Island, NY 10305-3408
Phone (718) 226-1458

300 Community Dr
Manhasset, NY 11030-3816

300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229

330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550

350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
010985NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince May 7, 2023 Accepting new patients
Northwell Health Current Accepting new patients

Locations

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

300 Community Dr
Plandome, NY 11030

256 Mason Ave
#C
Staten Island, NY 10305
Phone (718) 226-1251

256 Mason Ave
Bldg C3
Staten Island, NY 10305
Phone (718) 226-1300

256 Mason Ave
Bldg C
Staten Island, NY 10305
Phone (718) 226-1300

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: johnemmanueldelosreyes@northwell.allscriptsdirect.net
  • Direct secure messaging: jdelosreyes51585@northwell.direct-ci.com

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1831828136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 WILDBERRY CT",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 MASON AVE BLDG C3",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053408",
            "telephone_number": "718-226-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOS REYES",
        "first_name": "JOHN EMMANUEL",
        "credential": "MS, RDN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "010985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdelosreyes@northwell.edu",
            "affiliation": "N",
            "address_1": "256 Mason Ave Bldg C3",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103053408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.