Active NPI
Elsie Michelle Candelaria Reyes, DC
- Pediatric Chiropractor
- San Juan, PR
National Provider Identifier
1922526516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Chiropractor
- License
- 633
- Practice address
- 255 Ave Ponce de Leon Ste Lb126
San Juan, PR 00917 - Phone
- (787) 765-6507
- NPI assigned
- Sep 2, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Chiropractor | 111NP0017X | 633 | PR | Primary |
Addresses
Primary practice location
255 Ave Ponce de Leon Ste Lb126
San Juan, PR 00917
Mailing address
1476 Cond Puerta del Parque
Caguas, PR 00727-3147
Phone (787) 562-1194
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180627003006 | PR | Practitioner - Chiropractic | 5395091748 | Practice locations: San Juan, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 633 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1922526516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1476 COND PUERTA DEL PARQUE",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007273147",
"telephone_number": "787-562-1194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 AVE PONCE DE LEON STE LB126",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00917",
"telephone_number": "787-765-6507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANDELARIA REYES",
"first_name": "ELSIE",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-02",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "111NP0017X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Pediatric Chiropractor",
"state": "PR",
"license": "633",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.