Individual provider Active NPI

Javier Enrique Reynoso, P.A.

  • Medical Physician Assistant
  • McAllen, TX
National Provider Identifier
1871925180
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA08434 Issued in TX
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

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
363AM0700XMedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200327000659 TX Practitioner - Physician Assistant 6709215684 Reassigns benefits to 1 organization

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
Houston Carenow Urgent Care PLLCGroup PAC ID 7012291958, 113 clinicians

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

LicenseStateTypeSpecialty
PA08434TXMDMedical 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.

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

Verify at the official NPI Registry.