Mirabelle Reyes, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

02887 Issued in KY

Practice address

639 N Mulberry St
Elizabethtown, KY 42701-1931

Phone

(270) 737-4600

Fax

(270) 737-1722

NPI assigned

Jun 16, 2005

Last updated

Jun 29, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mirabelle Reyes Demuth Former name

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Anesthesiology

Education

Arizona College of Osteopathic Medicine Mid Western University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Apollo Medical Group of Jeffersonville LLCGroup PAC ID 8729487897, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Apollo Medical Group of Jeffersonville LLC

  • Anesthesiology Physician
  • Jeffersonville, IN
  • NPI 1124607205
  Medicare reassignment Care Compare group NPD
• Professional Anesthesia Services of Kentucky PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1992212807
  Medicare reassignment NPD
• Universal Anesthesia Services LLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1164696282
  Medicare reassignment NPD
• Apollo Medical Group LLC

  • Anesthesiology Physician
  • Rockport, IN
  • NPI 1396179461
  NPD

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1871598920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011931",
            "telephone_number": "270-737-4600",
            "fax_number": "270-737-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 N MULBERRY ST",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011931",
            "telephone_number": "270-737-4600",
            "fax_number": "270-737-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MIRABELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "02887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64101090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRABELLE",
            "last_name": "DEMUTH",
            "middle_name": "REYES",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kellina Elizabeth Renfroe, BSN, RN
• Resp-a-Care Inc (Rotech of Central Kentucky)
• Nathaniel Restivo, APSS
• Restoration DME Supplies, LLC
• Tanya F Revor, APRN-FNP
• Jason Harold Reynolds, M.D.
• Sarah Lavonne Reynolds, LCSW
• Shelby Marie Reynolds, RBT
• Rebecca Reza King
• Adam Rhein, DO

• Anesthesiology Physician in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Anesthesiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.