Individual provider Active NPI

Elpee Rica Dizon Reyes, RN

  • Critical Care Medicine Registered Nurse
  • Bridgeport, CT
National Provider Identifier
1982453155
Registry record updated May 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
196453 Issued in CT
Practice address
2800 Main St
Bridgeport, CT 06606-4292
Phone
(203) 576-6000
NPI assigned
May 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 196453 CT Primary

Addresses

Primary practice location

2800 Main St
Bridgeport, CT 06606-4292

Mailing address

441 Fairview Ave
Bridgeport, CT 06606-4602
Phone (346) 558-3736

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
196453CTMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1982453155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 FAIRVIEW AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064602",
            "telephone_number": "346-558-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066064292",
            "telephone_number": "203-576-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "ELPEE RICA",
        "middle_name": "DIZON",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CT",
            "license": "196453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.