Active NPI
Javier Enrique Reynoso, P.A.
- Medical Physician Assistant
- McAllen, TX
National Provider Identifier
1871925180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA08434
- Practice address
- 2901 W Nolana Ave Ste 10
McAllen, TX 78504-4896 - Phone
- (956) 558-6090
- Fax
- (956) 558-6095
- NPI assigned
- Aug 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA08434 | TX | Primary |
Addresses
Primary practice location
2901 W Nolana Ave Ste 10
McAllen, TX 78504-4896
Mailing address
3021 Torreon St
Hidalgo, TX 78557-3552
Phone (965) 802-6297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 363AM0700X | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10422 Research Forest Dr
Magnolia, TX 77354-6155
Phone (832) 702-7699
2901 W Nolana Ave
Suite 10
McAllen, TX 78504-4896
Phone (956) 558-6090
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA08434 | TX | MD | Medical Physician Assistant |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Magnolia, TX
- NPI 1093251860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1871925180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3021 TORREON ST",
"city": "HIDALGO",
"state": "TX",
"postal_code": "785573552",
"telephone_number": "965-802-6297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W NOLANA AVE STE 10",
"city": "MCALLEN",
"state": "TX",
"postal_code": "785044896",
"telephone_number": "956-558-6090",
"fax_number": "956-558-6095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOSO",
"first_name": "JAVIER",
"middle_name": "ENRIQUE",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-08",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA08434",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "363AM0700X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in McAllen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.