Individual provider Active NPI

Stefan M Zak Reyes

  • Student in an Organized Health Care Education/Training Program
  • Lexington, KY
National Provider Identifier
1861241283
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
780 Rose St MN 150
Lexington, KY 40506-0001
Phone
(859) 323-6161
NPI assigned
May 16, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

780 Rose St MN 150
Lexington, KY 40506-0001

Mailing address

200 Larue Apt 405
Lexington, KY 40517-8315
Phone (859) 707-0977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1861241283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LARUE APT 405",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405178315",
            "telephone_number": "859-707-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 ROSE ST MN 150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405060001",
            "telephone_number": "859-323-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK REYES",
        "first_name": "STEFAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.