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PORT ST. LUCIE PAIN & MEDICAL INSTITUE
NPI 1184307456
Pain Medicine - Interventional Pain Medicine in Oakland Park, FL

Active since August 11, 2023CLIA 10D2131659 · Waiver
4401 N ANDREWS AVE, OAKLAND PARK, FL 33309(954) 900-4686(954) 900-2655 Get Directions Write a Review

NPPES record last updated: March 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Port St. Lucie Pain & Medical Institue NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORT ST. LUCIE PAIN & MEDICAL INSTITUE (NPI 1184307456) is a healthcare organization registered as an interventional pain medicine in Oakland Park, Florida and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through June 4, 2027 and lists Ricardo J. Simmons, Manager, as its authorized official.

NPPES Registry Identity

NPI1184307456
Entity TypeOrganization
Primary Taxonomy208VP0014X
Legal Business NameLEOVIGILDO REYES MD PA
Location Address4401 N ANDREWS AVEOakland Park, FL 33309-3917
Mailing Address4401 N Andrews AveOakland Park, FL 33309-3917 · (954) 900-4686 · Fax (954) 900-2655
Phone(954) 900-4686
Fax(954) 900-2655
Organization SubpartNo
Authorized OfficialRicardo J. SimmonsManager · (954) 900-4686
Enumeration DateAugust 11, 2023
Last NPPES UpdateMarch 15, 2024
NPPES CertifiedMarch 15, 2024
✔ NPI 1184307456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0014X
Definition
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.
4401 N ANDREWS AVE, Oakland Park, FL 33309
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Other Names 1

Doing Business AsPort St. Lucie Pain & Medical Institue

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Port St. Lucie Pain & Medical Institue is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Port St. Lucie Pain & Medical Institue, which bills Medicare for the services this clinician delivers.

Clinician (1)

Leovigildo Reyes, M.D.
Interventional Pain Management
NPI 1104810399
4401 N ANDREWS AVE
Oakland Park, FL 33309
(954) 900-4686
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2131659

Port St Lucie Pain & Medical Institute · Oakland Park, FL
Active · expires Jun 4, 2027
CLIA Number10D2131659
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorLeovigildo J. Reyes
Laboratory Phone(954) 900-4686
Laboratory LocationPort St Lucie Pain & Medical Institute4401 N Andrews Avenue, Oakland Park, FL 33309
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leovigildo Reyes MD PA's NPI number?

The NPI number for Leovigildo Reyes MD PA is 1184307456. It was assigned to this organization in the NPPES registry on August 11, 2023. The provider is doing business as Port St. Lucie Pain & Medical Institue.

Where is Leovigildo Reyes MD PA located?

Leovigildo Reyes MD PA is located at 4401 N Andrews Ave, Oakland Park, FL 33309. The listed phone number is (954) 900-4686.

What is Leovigildo Reyes MD PA's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Is Leovigildo Reyes MD PA enrolled in Medicare?

Yes. Leovigildo Reyes MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Leovigildo Reyes MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Interventional Pain Management) reassigns their Medicare billing to Leovigildo Reyes MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Leovigildo Reyes MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2131659) is associated with this NPI, valid through June 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Leovigildo Reyes MD PA was last updated on March 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.