Active NPI
Alexis V Reyes, PSYD
- Psychologist
- Asbury, NJ
National Provider Identifier
1982270054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100639900
- Practice address
- 600 Main St
Asbury, NJ 08802-1352 - Phone
- (718) 506-1115
- NPI assigned
- May 31, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35S100639900 | NJ | Primary |
Addresses
Primary practice location
600 Main St
Asbury, NJ 08802-1352
Mailing address
21 Tallowood Dr
Glassboro, NJ 08028-9634
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100639900 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622419200000",
"number": "1982270054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 TALLOWOOD DR",
"city": "GLASSBORO",
"state": "NJ",
"postal_code": "080289634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 MAIN ST",
"city": "ASBURY",
"state": "NJ",
"postal_code": "088021352",
"telephone_number": "718-506-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ALEXIS",
"middle_name": "V",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-31",
"last_updated": "2021-05-31",
"certification_date": "2021-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100639900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.