Individual provider Active NPI

Florentino Gonzales Reyes, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1982749222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005334 Issued in NY
Practice address
155 W 19TH St
4TH Floor
New York, NY 10011-4121
Phone
(212) 929-2629
Fax
(212) 929-4971
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005334 NY Primary

Addresses

Primary practice location

155 W 19TH St
4TH Floor
New York, NY 10011-4121

Mailing address

155 W 19TH St
4TH Floor
New York, NY 10011-4121
Phone (212) 929-2629

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005334NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bisher Akil MD a Medical Corp Past Accepting new patients
Chelsea Village Medical Past 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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982749222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 W 19TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114121",
            "telephone_number": "212-929-2629",
            "fax_number": "212-929-4971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 W 19TH ST",
            "address_2": "4TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100114121",
            "telephone_number": "212-929-2629",
            "fax_number": "212-929-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "FLORENTINO",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.