Individual provider Active NPI

Michael Villanueva Reyes

  • Physical Therapist
  • San Antonio, TX
National Provider Identifier
1912764440
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1063360 Issued in TX
Practice address
9514 Console Dr Ste 102
San Antonio, TX 78229-2042
Phone
(210) 448-9111
Fax
(210) 308-9595
NPI assigned
Mar 1, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1063360 TX Primary

Addresses

Primary practice location

9514 Console Dr Ste 102
San Antonio, TX 78229-2042

Mailing address

9514 Console Dr Ste 102
San Antonio, TX 78229-2042

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1063360TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teamability, Inc. PastSince Mar 3, 2024 Accepting new patients
A Plus Pediatric Rehab, Inc. Physical Therapist PastSince Mar 3, 2024 Accepting new patients

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": "1709251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1912764440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9514 CONSOLE DR STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9514 CONSOLE DR STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292042",
            "telephone_number": "210-448-9111",
            "fax_number": "210-308-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA REYES",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-01",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1063360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.