Individual provider Active NPI

Carlos Alfonso Reyes Ortiz, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Houston, TX
National Provider Identifier
1962766642
Registry record updated Apr 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
44958 Issued in TX
Practice address
6431 Fannin St
MSB 5.111
Houston, TX 77030-1501
Phone
(713) 500-6295
Fax
(713) 500-0706
NPI assigned
Jun 27, 2012
Last updated
Apr 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 71399 GA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 44958 TX Primary

Addresses

Primary practice location

6431 Fannin St
MSB 5.111
Houston, TX 77030-1501

Mailing address

7675 Phoenix Dr
Apt 715
Houston, TX 77030-4700
Phone (409) 256-0290

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140816000148 TX Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0446477392 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
71399GAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 1, 2014 Accepting new patients
Ut Physicians CurrentSince Jun 1, 2014 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6431 Fannin St
#5111
Houston, TX 77030
Phone (713) 500-6295

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1962766642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7675 PHOENIX DR",
            "address_2": "APT 715",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304700",
            "telephone_number": "409-256-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "MSB 5.111",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6295",
            "fax_number": "713-500-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES ORTIZ",
        "first_name": "CARLOS",
        "middle_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "71399",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "44958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.